I 



& 



LIBRARY OF CONGRESsl 

UNITED STATES OF AMERICA. 



DR. DANELSON'S 

COUNSELOE 

WITH 

RECIPES: 

A PBACTICAL AND 

TRUSTY GUIDE FOR THE FAMILY, 

AND 

& Suiggestbe flanb-Sook far tfje Jtyijsician. 



J. EDWIN DANELSON, M.D., 

BEGULAB GBADTTATE, AND HOLDING OFFICIAL POSITIONS, ACTIVE MEMBERSHIP AND 

HONOBABY CONNECTION WITH MEDICAL, SUBGICAL AND THERAPEUTICAL, 

SOCIETIES IN THE CITY AND STATE OF NEW YOBK, ETC. 



SOLD BY SUBSCRIPTION'. 

NEW YORK: 

NICKLES PUBLISHING CO., 

697 Broadway. 

1880. 

7T • 



<A^ b 



Copyright by 
J. EDWIN DANELSON, M.D., 



[All Righto Reserved.] 



PUBLISHER'S CARD. 



In offering Dr. Danelson's Councilor to the 
public, we feel that we are meeting a want long 
felt by the household and by the people. In- 
variably we hear that works of like purport 
"contain everything and nothing at last." 
Practical and successful to an eminent degree 
in the practice of his profession, we were for- 
tunate in securing his services in a not untried 
field, that of an author. Although his energies 
for the past few years have been devoted al- 
most entirely to consultations, and the treat- 
ment of catarrh, lung, and chronic diseases, he 
has kindly consented to answer all communica- 
tions touching the subjects treated in this vol- 
ume, if sent to his address, Box 205, N. Y. 
City, gratis or otherwise, as the writer may 
deem proper. 

Orders for medicines should be sent to Doctor 
Danelson. Orders for books should be directed 
to the doctor or to this company. We want 
agents everywhere, and terms will be promptly 
sent upon application. 

Nickles Publishing Company, 

697 Broadway, New York. 



PREFACE. 



The majority of physicians, we believe, are prejudiced against 
books which popularize medicine ; and why, we fail to understand. 
They cannot reasonably object to every man, woman, and child 
having a correct, rather than a fanciful knowledge of physiology, 
of the operations and functions of the organs of their own bodies — 
in fact, of the life within themselves. Most doctors regret not hav- 
ing at an earlier period in their own lives possessed such informa- 
tion. Any opposition to the dissemination of the facts and princi- 
ples of hygiene will be futile, for the newspaper press has under- 
taken this form of education, and the avidity with which health 
articles are copied and recopied shows a desire for such. If the 
want is not met by the profession, who should be best qualified for 
the work, it will be supplied by the intelligent outside its ranks. 
At the present time this is the case to a great extent, and the whole 
subject is discussed ably and wisely by the laity. An exception 
may be noted in some of the largest publishing-houses, who are 
issuing small works in series on medical topics written by medical 
men. 

To talk of the "mystery of medicine" in this age is simply 
" foolishness," and it is equally out of place to assume the posses- 
sion of scientific knowledge far beyond the comprehension of the 
masses. If a physician knows exactly the condition of his patient, 
and the causes and consequences of his difficulties, he can explain 
them so as to be understood by the least intelligent. 

There exists altogether too much ignorance on medical matters. 
People act, if they do not speak, as though it was not necessary to 
use reason and common-sense in medicine the same as in other 
matters. This ignorance compels a multiplication of words by 
the doctor in giving instructions ; and his successes are as often 
thwarted by some imprudence which he failed to forbid or proscribe, 
as from disregarding instructions which a knowledge of physiol- 
ogy would have averted. It is a sad mistake to believe that popu- 
lar medicine injures a physician financially or otherwise. The in- 
formed will look after minor matters, it is true, and perhaps they 
will do this in any event ; but when skill is wanted they call early, 
seldom arouse one at unseasonable hours, make the visit a3 cheer- 



vi PREFACE. 

fill as can be tinder the circumstances, relieve one of the necessity 
of looking after minor details, appreciate the services rendered, 
pay for it promptly, and enhance one's reputation by assisting in 
speeding the cure. The only one to suffer is the pretender, the 
impostor. A moment's reflection will convince any one of the fact. 
Persons who are sharp in bargains, shrewd in business, and saga- 
cious in most of the concerns of life, have little knowledge of the 
principles of medical practice, and seldom scrutinize or criticise 
the man into whose keeping their lives are entrusted, — his methods, 
or their progress. Among these, a little learning would be danger- 
ous to the pretensions of the charlatan. We would not believe that 
this prejudice is founded upon any such fears as here depicted. 
If it is, we would gladly hasten the day of more complete knowl- 
edge. We suggest that in the education of the masses lies an easy 
solution to the problem of ridding the country of empirics, now 
endeavored to be accomplished by legal enactment. 

Perhaps physicians are prejudiced against books which popular- 
ize medicine, from a belief that too much medicine would be taken, 
and disease be increased instead of lessened. This ground is hardly 
tenable. The selfish would welcome the more extensive harvest ; 
but there is no danger of immediate results one way or the other. 
Few have any idea of the hogsheads and tons of patent medicines 
taken ; and we doubt if there was ever more medicine swallowed 
than at the present time, and yet the average duration of life is in- 
creasing. Perhaps one has little to do with the other, but it is a 
good illustration of overdosing. Such books generally advise but 
few remedies, and these not injurious. There are exceptions, but 
they are few. 

Again, such works teach physiology and hygiene, and if the in- 
structions are followed, disease is prevented. Besides, a person 
using one of these recipes watches its effects much more closely than 
that received from a physician, and if ineffective throws it aside, 
and uses another if he chooses — a liberty which he should take, but 
does not care to take with the doctor's remedy. 

Another objection to the education of the people in the rudi- 
ments of medicine is, that when they employ a physician they will 
not follow his advice. This argument is theoretical only, and we 
have already noticed its practical effects to be quite the contrary. 
If a patient does not follow instructions, the responsibility and risk 
are his own. It is not so certain but he may know of a better way 
than the course recommended. Physicians and nurses we know 
often disagree, but this is seldom the case when the nurse is edu- 
cated. A common-sense view may differ from the scientific opin- 
ion. Medicine needs both the common-sense and the scientific ; 
but when a seeming conflict does come, let the so-called scienti- 



PEEFACE. vii 

fie give way to the other, that no mistake may happen, and no in- 
jury. 

Such prejudices compel the mother with her first babe to seek 
the physician for answers to the thousand and one questions ever 
rising in her mind concerning its care, its welfare, and its physical 
training. They compel the timid to suffer, which they would 
rather do than consult a doctor for information on sexual matters. 
They would, if the people would concur, foster such ignorance that 
health would be continually jeopardized. Such sentiments do not 
accord with that philosophy which declares, "I am a man, and 
nothing which affects humanity should be a matter of indifference 
to me." 

There are serious objections to some "popular medical works" 
on the ground of immorality. The most dangerous book to public 
morality, we believe, is one professing to be written by a physician, 
who advocates universal lust and license as a matter of science and 
physiology. This book expresses boldly the carefully whispered 
opinions of some medical men, who, immoral themselves, advise 
the readers, male and even female, to practise immorality, just as 
doctors who freely indulge in intoxicating drinks also freely pre- 
scribe them for their patients. All this is fearfully wrong, and 
fearfully mischievous, as any one can see who looks beneath the 
varnished surface of respectable society, as can be shown from the 
highest authority, and as a deduction of physiological science ; for 
nothing which is not contrary to nature can be opposed to a true 
morality. 

In the pages which follow an effort is made to avoid all objec- 
tionable features. General terms are as far as possible omitted. 
To advise patients to use tonics, leaving the selection and adminis- 
tration to their untutored judgment, is wrong. When such occur, 
it better be interpreted, Consult a physician. To the discretion, 
however, is left either the size of the dose or frequency of dispens- 
ing it. These must always be decided by the urgency and emer- 
gency. The doctor is himself often puzzled in this matter. Each 
disease is treated by itself, repeating the recipes when proper, 
and taking the chances of being considered verbose. 



TABLE OF CONTENTS. 



MEDICAL DICTIONARY 16 



PART I. 

PHYSIOLOGY. 



Page 

Vital properties 25 

Five nerves to each muscle 26 

Reserve force 27 

Suspended animation. 28 

Vital principle 29 

Disease denned 31 

Structural disease 33 

Nutrition and secretion.. 34 

Food elements 35 

Hibernation 37 

Digestion 37 

Biliary functions 41 

Pancreatic juice 41 

Intestinal juice 42 

Constipation 43 

Lymphatic glands 44 

Circulation of blood 45 

Offices of the blood 46 

Respiration 47 

Suspended respiration 49 

Crowding in rooms 50 

Diseases from impure air 51 

Indigestion 51 

Blocd flowing to a part 53 

Assimilation. . 53 

Absorption 54 

Elements of the blood 55 

Effects of loss of blood 57 

Venom of insects and animals 58 

Blood -poisons 59 

Excretion 61 

Bilious complaints 61 

Elements of bile 62 

The bile and cathartics 63 

Functions of the kidneys 64 

Quality of the urine 65 

Abnormal urine 67 

Neglect causing female diseases 68 

1* 



Page 

Functions of the skin 69 

Anatomy of the skin 69, 70, 632 

Cutaneous exhalation 71 

Absorption by the skin. 73 

The excretion by the bowels 73 

Starchy food for infants 74 

Bowel disorders 74 

Elements of disease : congestion, fever, 

dropsy, inflammation 75 

Elements continued: suppuration, ab- 
scess, tubercle, cancer, gangrene 76 

Organic diseases 77 

The Nervous System 77 

Sympathetic nervous system 78 

Structure of ganglia 78 

Functions of nerve-centres 79 

Injuries to ganglia 81 

Vital operations 83 

Functions of the sympathetic system. . . 85 

The brain and spinal nerves 87 

Intercommunication of nerves 89 

Nerves classed — special sensation, sensi- 
bility 91 

Motion 92 

Functions of the brain 92 

Mental faculties 93 

Phrenology 94 

The cerebellum, or lower brain 96 

The medulla oblongata 96 

The cerebro-spinal nerves 98 

The trifacial nerve 98 

Functions of the cerebral nerves. .98, 99, 100 

The spinal nerves 101 

Diseases of the nerves 101, 102 

Causes of nervous disorders 102, 103 

The nervous energy 105 

Causes operating to produce sensative 
and morbid conditions of the body. . . 106 



10 



TABLE OF CONTENTS. 



PART n. 
HYGIENE. 



Page 

Its importance 108 

Its difficulties. 109 

Epidemics brought by food, air, or 

water 110 

Organic matter poisonous Ill 

Diseases preventable 112 

Hygienic laws versus medicine 112 

Diet 113 

Meat as food 115 

Meat for brain-workers 116 

Fish and eggs 118 

Wheat 119-125 

Fruit 125 

How to eat 126 

Food for invalids 127 

Beef tea 127 

Poisoning by lead in cooking utensils. . 128 

Test for lead 130 

Arsenical walls 132 

Water 133 

Cisterns 135 

Pure air 135 

Ventilation 139 



Page 

Ventilation by bed-rooms. 139 

Sunlight 141 

I Bathing 142 

; Indoor exercise 144 

Results of exercise 151 

Sleep 152 

After-dinner naps 153 

Sleeping together 153 

I Clothing • 154 

I Women's dress 157 . 

| Mourning suits 158 

I Requisites for dwellings 160 

j Drainage 161 

Sewage and drainage 165 

Baths 168 

; Local and shower-baths 168, 169 

| Turkish and Russian baths 170 

! Portable Turkish bath 171 

j Spirit-vapor bath or alcoholic-vapor 

| sweat 172 

j Wet sheet pack 173 

1 Compresses 174 



PART m. 
MARRIAGE. 

Historically, philosophically, and physi- | ologically considered. 175-193 



PART IV. 

MEDICAL PRACTICE. 

Introductory Chapter. 

Proper sphere of remedies 193 Sickness in the farm-house 208 



Practitioners 194 

Different schools 195 

Its mysteries 195 

Popular knowledge necessary. ; 15*6 

The physician's attainments 

The physician's status 

The model doctor 201 



Nervous diseases 210 

Ennui , 211 

Cheerfulness 213 

: Imagination and will 213 

Fear, confidence, and other influences. 216 

Efforts to avert disease 219 

Transmission of disease. . 



Nature the source of remedial power. .. 203 Influence of sexual sins, of drunken- 
Smaller doses 204 ; ness, and other parental vices 221-224 

Professional errors 204 Proper food 224 

Boards of health 205 Change of diet 225 

Epidemics 206 Medicinal action of water 225 

Contagion 206 Nursing 225 

Mortality causes 207 Diet for invalids 227 

Hygiene 207 : Exercise for invalids. 227 

Close confinement of the sick 207 I 



TABLE OF CONTENTS. 

MEDICAL TREATMENT. 

Elements of Disease. 

Page 

Irritation, congestion, and Mamma- I Fever 

tion 230 Disinfectants : general rules. . 

Hemorrhage. 233 J 



11 



CLASS I.— Zymotic Diseases. 



Order I. — Miasmatic Diseases. 



Intermittent fever, chills and fever, 

ague, dumb ague 241 

Remittent fever, miasmatic or mala- 
rial fever, bilious fever 245 

Typhoid fever, nervous fever, abdomi- 
nal fever, enteric fever 247 

Contagion and disinfection of tvphoid 

fever 250 

Typhus fever, contagious typhus, brain, 
malignant, putrid or petechial fever, 

hospital, jail or ship fever. 252 

Congestive fever, pernicious fever 253 

Yellow fever, black vomit, Yellow Jack. 255 

Measles 257 

Black or putrid measles 259 



Scarlet fever, scarlatina, canker-rash . . 259 

Scarlatina simplex 260 

Scarlatina anginosa 260 

Scarlatina maligna 261 

Disinfection of scarlet fever 263 

Small-pox 265 

Varioloid 266 

Vaccination 267 

Chicken-pox 268 

Hectic fever 270 

Night-sweats . . 270 

Cholera, Asiatic, Indian, Oriental, spas- 
modic, pestilential 271 

A list of other miasmatic diseases, but 
considered under other headings .... 273 



Order II.— Enthetic {Inoculated) Diseases. 

Hydrophobia, canine madness 274 ! Bites of fleas, mosquitoes and bedbugs. . 280 

Bites of poisonous snakes, spiders, etc. . 278 , Poisoning by vines and shrubs 281 

Stings of bees, wasps, hornets, etc 280 | 

Poisons— not inoculated. 



Acids 284 

Alkalies, alcohol 285 

Aconite, antimony, arsenic ... 286 

Belladonna, cantharides, chloroform, 

and ether 287 

Copper, gelseminum, hemlock 288 



Iodine, ivy, lead, mercury, mushrooms. 289 
Opium, morphine, potassium, phospho- 
rus, strychnine 290 

Tobacco, veratrum viride, zinc 291 

Unknown poisons 292 



Order III. — Dietic Diseases. 

Scurvy 293 I Alcohol disease 295 

Rickets 293 i Delirium tremens 297 

Goitre 294 , Opium-eating habit 298 



Order IV. — Parasitic Diseases. 
300 | Pork or sausage poison 304 



12 TABLE OF CONTENTS. 

CLASS II.— Constitutional Diseases. 
Order L — Diathetic Diseases. 

Page Page 

Rheumatism, acute or inflammatory . . . 306 Leucocythaemia 313 

Gonorrhceal rheumatism 3U7 Addison's disease 313 

Chronic rheumatism 308 Green sickness 313 

Lumbago 308 Dropsy 314 

Wry-neck 309 Dropsy of the brain 315 

Sciatica 309 Hydrocele 316 

Gout 311 Hydrothorax 817 

Bloodlesaness 312 , Cancer 319 

Order II. — Tubercular Diseases. 

325|Marasmus 327 



CLASS III. — Local Diseases. 
Order I. — Diseases of the Brain and General Nervous System. 

Inflammation of the brain, brain fever, I Mental Debangement 

frenzy 329 Insanity 350 

Spotted fever 330 Brain-work 352 

Cerebro-spinal meningitis 330 Inebriety 357 

Concussion of the brain 333 Falling sickness, fits 359 

Sunstroke 334 Hysteria 361 

Headache 336 Catalepsy and trance 363 

Dyspeptic, sick, and nervous headaches 337 Saint Vitus's dance 364 

Neuralgic, rheumatic, gouty, bilious Lockjaw 364 

and congestive headaches 338 Convulsions 366 

Sleeplessness 341 Nine-day fits 867 

Nightmare and day mare 342 Palsy, paralysis 368 

Dreaming 343 Nerve -pain, "neuralgia 370 

Somnambulism and somnolency 344 Faceache 373 

Coma 344 Neuromimesis 374 

Progressive locomotor ataxia 346 Stammering and stuttering. 374 

Sof tening of the brain 347 , 



Order II. — Diseases of the Eye. 

Inflammation of the eye 377 j Inflammation of the eyelids 381 

dranular lids 379 , Squinting, cross-eyes 382 

Opacity of the cornea 379 Foreign bodies in the eye 383 

Amaurosis 380 : Smoker's eyes 384 

Color-blindness 881 ; Protection of vision 385 



Order III.— Diseases of the Ear. 



Anatomy of the ear 388 Running from the ear 

Inflammation of the ear 889 Foreign substances in the ear. . 

Earache 390 I 



TABLE OF CONTENTS. 



13 



Order IV. — Diseases of the Nose* 

Page Page 

Catarrh, ozsena, influenza 394 I Acute catarrh, snuffles 404 

Nasalpolypus 403 Nosebleed 406 

Ulceration of the antrum , . . . 403 



Order V. — Diseases of the Mouth, Fauces, and (Esophagus. 



Diseases and care of the teeth 408 

Spongy gums, loose teeth, and disagree- 
able breath 408 

Toothache 410 

Decaying teeth 411 

Dentition 414 

Inflamed or elongated uvula 417 



Pharyngitis 418 

Mumps 419 

Inflammation of the tonsils, quinsy 420 

Choking 422 

Snoring 423 

Diphtheria 424 

Inflammation of the gullet 425 



Order VI. — Diseases of the Heart. 

Carditis 428 | Fainting, swooning. .. 

Palpitation of the heart 430 i Giddiness, dizziness. . . 

Blue disease, blue jaundice 431 J 



Order VII. — Lung Diseases. 



Colds and coughs < 

Inflammation of the larynx < 

Croup < 

Crowing disease, false croup < 

Loss of voice ' 

Bronchitis < 

Whooping-cough, chin-cough - 

Asthma < 

Hay fever, hay asthma, summer catarrh, 

rose catarrh . . < 

Pleurisy < 



Lung fever, pneumonia 455 

Consumption, phthisis 459 

Hemorrhage from the lungs 463 

Wind dropsy, emphysema 475 

Wind in the chest 475 

Abscess of the lung 475 

Collapse of the lung 475 

Short breath, difficult breathing 476 

Foreign substances in the trachea 476 

Suspended animation, suffocation 477 

Artificial respiration 479 



Order VIII. — Bowel Diseases. 



Inflammation of the stomach 482 

Indigestion, dyspepsia 484 

Ulcer of the stomach 486 

Cancer of the stomach 486 

Hiccough •. 4S7 

Inflammation of the liver 488 

Jaundice, janders, yellows 489 

Hobnailed, nutmeg, gin, or granular 

liver 490 

Other diseases of the liver 491 

Stone, gravel 491 

Gall-stones 493 

Inflammation of the spleen 4'.)3 

Inflammation of the bowels 495 

Peritonitis . . 496 

Collie, belly-ache 497 



| Lead, or painters' colic 500 

j Summer complaint, cholera infantum.. 501 

J Cholera morbus. . 603 

j Hernia 505 

Purging, looseness of the bowels, diar- 

j rhcea 506 

; Dysentery, flux, bloody flux 508 

! Constipation 610 

; Obstructions in the bowels 512 

! Diseases of the rectum 514 

: Anal fistula 515 

Fissure 516 

Falling of the rectum 516 

Stricture of the rectum 517 

I Hemorrhoids, piles 518 



14 



TABLE OF CONTENTS. 



Order IX.— Diseases of the Kidneys and Bladder, 
Page 
Inflammation of the kidneys, renal con- 

gestion 521 

Bright's disease j>f« 

Bloody urine, hematuria 524 

Uraemic poisoning 524 

Sugar in the urine, diabetes 52o 



Page 

Irritation of the bladder 526 

Inflammation of the bladder 527 

Retention of urine 530 

Incontinence of urine, dribbling 531 

Suppression of urine 534 



CLASS rv.— Genetic Diseases. 
Order I.— Of Men. 

Emissions 535 I Varicocele.. 561 

Continence. 536 I Clap, gonorrhoea.. 563 

Spermatorrhoea 53S j Stricture of the urethra 5b6 

Impotence 559 Circumcision 568 

Inflamed testicle, swelled testicle 561 | Pox, syphilis 569 



Order II.- 



Love 

Puberty 

Chastity 

Wedding journeys 

Objections to maternity considered 

Incapacity reviewed 

Sterility of barrenness 

Maternity 

Signs of pregnancy 

Diseases of pregnancy 

Labor 

The bandage 

Abortion, miscarriage, premature la- 



572 
573 
574 
574 
575 
576 
577 



bor. 



Child-bed fever, puerperal fever 

Puerperal convulsions 

Puerperal mania 



, 595 

597 

. 598 



-Of Women. 

Amenorrhcea 599 

Painful menstruation, dysmenorrhea. . 601 

Menorrhagia 603 

Vulvitis 603 

Vaginitis 604 

"Womb diseases 604 

Displacements 605 

Falling of the womb 606 

Female weakness 609 

Whites, leucorrhcea 615 

Milk-leg, white swelling 619 

Diseases of the breasts 621 

Inflammation of the breasts 621 

Broken breast, milk abscess 622 

Weaning 623 

Sore nipples 624 

Change of life, turn of life 624 



CLASS V.— Bone, Muscle and Skin DisEASEa 
Order I. — Spinal Diseases. 

Spinal irritation 627 ' Sideache 631 

Curvature of the spine, hump 628 ■ Knee-joint disease 631 

Backache, lame back 630 | 

Order II. — Diseases of the Skin. 



Anatomy of the skin 69, 70, 

Pimples 

Causes of skin diseases 

Rash and vesicles 

Pustules and dry pimples 

Dandruff 

Tan, freckles, and liver-spots 

Ringworm of the scalp 

Baldness 

ErysipHns 

Boil, funinculus 



Malignant boil, anthrax 



H32 Carbuncle 654 

684 Kunround, felon, whitlow 655 

635 ! Corns 656 

639 Warts 658 

641 Bunions 658 

643 Fetid feet, stinking feet 659 

645 Incurved or ingrowing toe-nails 6H0 

8 1»"» Call, chafe, and chap W0 

647 Frost bite ; freezing to death 6<il 

64« Chilblains 6I>2 

651 Burns and scalds 668 

652 Kerosene lamp explosions 665 

653 Bruises 666 



TABLE OF CONTENTS. 15 

CLASS VI.— Developmental Diseases. 

Diseases of Nutrition, 

Page Page 

Corpulency, obesity 667 I Bow-legs and knock-kneea 670 

Debility, general debility, weakness 670 | 

CLASS VII.— Sukgical Diseases. 



Wounds 672 

Bed-sores, old sores, ulcers, festers 674 

Varicose ulcer or veins 676 

Fracture 676 

Scars 677 



Stitches, strains and sprains 678 

Lightning stroke 679 

Diseased condition^ following wounds.. 679 

Caries and necrosis 680 



Concluding Chapters. 



Medical Appliances. 

Spring-pad truss 688 I Electrical machine 692 

Bespiratory brace 690 | 

Domestic Medicines. 

Domestic remedies : a brief description I Pharmacy 700 

of their properties and uses. 694 | List of domestic remedies 704 



MEDICAL DICTIONARY. 



ABATEMENT. Decrease of fever. 
Abdomen. The belly. 

Abnormal. Unnatural, irregular. 

Abscess. A collection of. purulent matter. 

Absorption, absorptive. Taking up or soaking np. 

Acephalous. Without a head. 

Acid. Sour : a substance which neutralizes alkalies. 

Adhesive strips, adhesive plaster. Cloth or other material coated on one side with stick- 
ing composition. 

Afterbirth. A body attached to the womb and by a cord to the child, supplying blood and 
nourishment before birth. 

Albumen, albuminous. One of the elements of the body that hardens with heat. The 
white of an egg. 

Aliment, alimentary. Food. The alimentary canal begins with the mouth and ends 
with the rectum. 

Alkali. Caustic ; a substance which neutralizes acids. 

Alterative. Altering or purifying the blood. 

Alternating. One medicine following another after an interval. 

Altruism. Regard for another. 

Alveoli. The bony sockets to the teeth. 

Alvine. Pertaining to the intestines. 

Anaemia. Deficiency in blood. The want of red corpuscles gives the pallid appearance 
to the skin. 

Anaesthesia. Deprived of sensation. 

Anaphrodisiac. An agent to blunt sexual appetite. 

Anastomosis. Communication between blood-vessels. 

Anatomy. A description of the organs of the body. 

Anodyne. Relieving pain. 

Antacid. Neutralizing acid. 

Antibilious, A term applied to active cathartics. 

Antidote. Medicines counteracting poisons and rendering them inert. 

Anti-malarial. Preventing an attack of malaria. 

Antiperiodic. Breaking up periodicity or appearance at regular intervals. 

Antiperistaltic. Forcing the contents of the bowels backward into the stomach. 

Antiseptic. Destroying poison. 

Antispasmodic. Stopping spasms. 

Antrum. See pa^o 408. 

Anus. The lower opening of the bowel. 

Aorta. A large artery arising from the heart. 

Aperient. A gentle laxative or purge. 

Aphonia. Lo-s of voice. 

Aphthous. Affected with aphtha; ; a curd-like covered pore. 

Areola, areolar. The connecting tissue between fibres and vessels. Pertaining to areolae. 

Artery. A blood-vessel which (with one exception) carries the red blood. 

Asphyxia. Suspended animation. See page 477. 

Aspirator. A pumping apparatus with a long, fine, sharp-pointed tube for removing fluid* 
from internal parts. 

Assimilation. The act of transforming the food into the various parts of the body. 

Asthenic. Debilitated. 

Atrophy, atrophied. Wasting away. Withered. 

Auscultation. Discovering chest diseases by listening. 

Axillary. Arising from a depression between the stem and leaf -stock. 



MEDICAL DICTIONARY. 17 

BANDAGE. A long piece of cloth, of variable width, used for binding. 
Benumb. To deprive of sensibility. 
Bicuspid teeth. The fourth and fifth teeth from the centre of the lips. 
Bile, bilious. A fluid secreted by the liver. Pertaining to bile : a peculiar temperament. 
Blastema. A germ. 

Bloodletting. Opening a vein in the arm to let out blood. 
Bolus. A large pill or anything of its size. 
Bougie. A flexible instrument for dilating the urethra. 
Bronchial tubes. Vessels carrying air to the lungs. Bronchi. 
Bronchus, bronchi. The lower air-passage. 
Buccal walls. Inner surface of the cheeks. 

CACOPLASM. Bad or low form of organization. 
Cxcum. A part of the intestines emptying into the colon ; the blind gut. 

Calcareous. Of the nature of lime. 

Calculus, calculous. A stony formation. Pertaining to calculus. 

Capillary. Blood-vessels, hair-like in size. 

Capsule. A covering or case. 

Carbon. One of the elementary bodies or metalloids. 

Cardiac. Pertaining to the heart. 

Carnivora. Flesh-eating animals. 

Cartilage, cartilaginous. A white, elastic, solid part of the body. Gristle. Cristly. 

Caseous. Like cheese. 

Castration. Removing the testicles. 

Oatamenial. Relating to the monthly flow. 

Cathartics. Agents that produce evacuation of the bowels. 

Catheter. A tube with an eyelet near its end, used for conveying fluids. See illustrations, 
pages 529 and 531. 

Caustics. Corrosive or burning substances. 

Celibate. A bachelor. 

Cell. The smallest particle of living matter. The body and all of its parts are made up 
of cells. 

Cellular tissue. The tissue uniting all parts of the body. 

Cerebellum. The small or lower brain. 

Cerebrum. The great or upper brain. 

Cerumen, ceruminous. Ear-wax. Waxy. 

Cholesterine. A crystallizable substance formed in the bile. 

Chronic. Long-standing, seated. 

Chyle. The milky fluid formed from digested food, and which is emptied directly into 
the blood-vessels. 

Chyme. See page 38. 

Cicatrix, cicatrices. The scar from a wound. Scars. 

Circulation. The flow of blood from the heart to the extremities and back again. 

Circumcision. See page 568. 

Clonic. Rigid, with occasional relaxation of the muscles. 

Coagulate. To harden, as the white of an egg, by boiling. 

Coitus. Sexual connection. 

Collapse. Complete prostration or inaction. 

Colliquative. Exhaustive. 

Coma. Comatose, profound sleep. See page 344. 

Conception. Being with child in the womb. 

Congenital. Dating from birth. 

Congestion. The flow of blood to a part. Stagnant circulation. 

Conjunctiva. The membrane covering the ball of the eye and inner surface of the eye- 
lids. 

Contagion. Communication of disease from one to another by touch, food, drink, or 
the atmosphere. 

Continence. Abstinence from sexual congress. 

Convalesce, convalescence. To recover health and strength. Period of recovery. < 

Convulsions. Spasms. 

Cornea. The tough transparent membrane in the front of the eyeball. 

Corpuscle. A minute body. A particle. 

Corroborant. A remedy which gives strength ; tonic. 

Corrosive. Burning. 



18 GLOSSARY. 

Cortical. The bark or external portion. 

Costiveness. Irregular and delayed motion of the bowels. Constipation. 

Counter-irritation. Irritating one part to relieve irritation in another. 

Cramps. Sudden and painful contractions of muscles. 

Cranial. Belonging to the skull. 

Crisis. The period of change ; it may be to worse or to better. 

Cul-de-sac. A pouch. 

Cupping. Drawing blood by lancing, and the application of a heated cup. 

DECUSSATE. To cross each other. 
Defecation. Evacuation of the bowels. 
Dejections. Matter voided from the bowel. 
Delirium. Mental aberration. 
Deltoid muscle. A muscle passing over the shoulder and terminating at the centre and 

outer part of the upper arm. 
Depurative. Purifying. Removing impurities. 
Dextrine. A substance obtained from starch. 
Diagnosis. Discovery of a disease by its symptoms ; discriminating between a disease 

and others with which it may be confounded. 
Diaphoretic. Inducing perspiration : sweating. 
Diaphragm. The muscle separating the chest and its contents from the abdomen and 

its contents. 
Diastaltic. Keflex action induced by the spinal marrow. 
Diathesis. Tendency of the constitution to a particular disease. 
Diathetic. Kelating to predisposition to disease. 
Dietic, dietetic Kelating to the food and drink. 
Digestion. Conversion of the food into form suitable for nourishment and into refuse or 

excrement. 
Disinfectant. Purifying or cleansing from infection. 
Diuretic. Increasing by secretion the quantity of urine. 
Dram. One eighth of an ounce, or a teaspoonful of fluid. 
Drastic. Very powerful cathartic action. 
Duct. Canal. 

Duodenum. The first part of the intestines. 
Dysmenorrhoea. Painful menstruation. 
Dyspnoea. Difficult breathing. 

ECONOMY. The parts constituting the body or the laws governing them. 
Effete. Worn out: useless. 
Effusion. Escape of a fluid. 

Elimination. Ejection by stimulating the secreting organs. 

Eliminatives. Agents which expel substances from the body, as by the skin, kidneys, etc. 
Emaciation. Loss of flesh. 

Embryo. The animal in its earliest existence in the uterus. 
Emesis. Vomiting. 
Emission. See pages 535, 538. 

Emulsion. A pharmacal compound of oil and water. 

Emunctory. Any organ of the body acting as the outlet of effete and worn-out matter. 
Enceinte. Pregnant. 

Encephalon. The head ; all within the head. 
Encysted. Covered with a membrane or sac. 
Endosmosis. Fluids passing through membranes into structurci. 
Enema. Liquid ii.jectionB into the bowel. 
Enervation. Weakness. 
Enteric. Intestinal. 
Entozoa. Worms. 

Epidemic. A disease attacking many individuals in a locality at the same time. 
Epithelial. Relating to the thin covering to the eyes, lips, mouth, intestines, and the like. 
Erosion. Corrosion ; eating away. 
Erosis. Amatory paetion. 

Eructations. Wind or gam raised from the stomach with some noise. 
Essence, essential. The active principle of plants. A diluted oil. 

Eustachian tube. A canal about two inches in length connecting the ear and back of the 
mouth (pharynx). 



MEDICAL DICTIONARY. 19 

Exacerbation. Increase in fever. 

E xanthomatous. . Attended with fever and skin eruption. 

Excito-motory. Reflex nervous action. 

Excito-nutrient. Affecting nutrition by reflex nervous action. 

Excito-secretory. Affecting secretion by reflex nervous action./ 

Excrement, excrementitious. Matter ejected from the bowel. 

Excretion, excretive. The faculty of selecting and discharging from the system fluids, 
as in sweating and in urine, useless matter as in feces, and impurities by either. 

Exhaling. Breathing out ; throwing off vapor. 

Expectorant. Remedies which loosen phlegm in the air-passages, and hence facilitate its 
discharge and relieve oppressed breathing. 

Expectorate. To discharge mucosities by coughing and spitting. 

Expiration. Exhaling air by the lungs. 

Extravasate. To escape from the containing vessel and permeate the surrounding tex- 
tures. 

Exudation. Escaping or discharging through pores. 



FARINACEOUS. Containing farina or flour. 
Fascicles. Little bundles of fibres. 

Fauces. The back of the mouth and upper part of the throat. 

Feces, fecal. That part of the food remaining after digestion and which is ejected at in- 
tervals from the bowels. 

Feculent. Foul. 

Fermentation. Chemical action and combination by which new substances are formed. 

Fibre, fibrous. The hard, elastic, organic particle which, aggregated, forms muscle and 
other tissues. 

Fibrine. An organic substance, fluid, coagulable, found in the blood, lymph, etc. 

Filaments. A thready fibre. 

Flagellation. Flapping the body with the corner of a wet towel or the snap of a whip. 

Flatulence. Wind in the stomach and bowels. 

Foetus, foetal. The young of any animal during uterine existence. Pertaining to the un- 
born. 

Follicle. A little depression throwing off moisture to keep the contiguous part soft and 
supple. 

Foreskin. The prolonged skin of the penis, which covers the glans or head. 

Fumigation. Disinfection by gas, smoke, or vapor. 

Function. The normal or healthy action of an organ. 

Fundament. The seat; anus. 

Fungus. Parasitical plant. 



GANGLION. Masses of nerves resembling brain. 
Ganglionic. Composed of ganglia. 

Gangrene. Mortification ; local death. See page 679. 

Gastric juice. The digestive fluid secreted by the stomach. 

Generative. Productive. 

Genetic. Pertaining to the genital organs. 

Genitals. The generative organs. 

Germ theory. The theory of the propagation of disease by germs floating in the atmoB- 
phere. 

Gestation. The period of carrying the young in the womb. 

Glands, glandular. Organs of the body, each possessing vital properties peculiar to it- 
self, as secretion of tears, milk, saliva, urine, excretion, etc. 

Glans. The conicul end of the penis, covered by the foreskin. 

Gluten. The ingredient in flour (farinae) which gives it adhesiveness. 

Grain. One sixtieth of a dram. 

Graminivora. Grain-eating animals. 

Granular. Consisting of little grains. 

Granules. Little grains. 

Griping. The pains of colic. 

Gullet. The canal for food leading from the throat to the Ptomach. 

Gynaecology. That part of the science of medicine devoted to the diseases of women. 



20 GLOSSARY. 

HECTIC. Debilitated ; exhausted. 
Hereditary. Transmitted from parent to child. 

Hibernate, hibernation. A partial suspension of animation. Animals that Bleep 
through the winter, hibernate. 

Histogenetic. Tissue-form ng. 

Hydragogues. Medicines producing copious, watery, alvine discharges. 

Hydrocarbons. Starch, sugar, and oils. 

Hydrogen. A light, inflammable gas, forming, by chemical combination, water and ani- 
mal and vegetable matter. 

Hygiene, hygienic. The science of the preservation of health. 

Hymen. A fold of membrane at the outer orifice of the vagina, found sometimes, but 
not always, in virgins. 

Hrpertrophy. Increased nutrition and consequent growth. 

Hvpnotic. Producing sleep. 

Hypochondriasis. Belief in the possession of an imaginary disease. 

Hypodermic. Under the skin. 

Hypodermic syringe. An instrument for injecting liquid remedies under the skin. 

ILEUM. The convoluted portion of the intestines. 
Impotence. Loss of sexual power ; inability to copulate. 
Indications. The symptoms or conditions needing medication. 

Infection, infecting. The communication of disease by touch, food, drink, or the breath. 
Infeeundity. Unfruitfulness. 
Infiltrate. To penetrate the pores of a part. 

Inflammation. A condition attended with heat, pain, redness, and swelling. 
Injection. Pissing a liquid into a cavity of the body, through and by means of a syringe. 
Innocuous. Harmless. 

I loculation. Taking a disease by contact with an abraded surface. 
Insolation. Sunstroke. 
Insomnia. Inability to sleep. 
Inspiration. Inhaling air by the lungs. 
Inspissated. Thickened by evaporation. 

Instinct. An inborn principle directing to health and self -preservation. 
Intercostal. Between the ribs. 
Intestine, intestinal. The canal from the stomach to the anus ; the bowels. Relating 

to the intestines. 
Invermination. Infested with- worms. 
Iris. The colored membrane seen in the eyeball ; it is blue in blue eyes, gray in gray 

eyes, etc. 
Irritation. Local excitement, or excess of vital action. 



K 



IDNEYS. Two organs, one on each side of the spine, internally and above the 
small of the back, which secrete the urine from the blood. 



T ACHRYMAL gland. Organ for forming tears. 

-* — ' LacUrymation. Weeping. 

LacteaL Milky. Vessels containing chyle. 

Larynx. The Adam's apple of the neck ; the upper part of the windpipe which contains 

the organs of voice. 
Lancinating. A deep and sudden pain, compared to the stab of a lanco. 
Leeching. Removing blood by the application of a leech. 
Lesion. A diseased change. 
Leucocytes. White corpuscle* of the blood. 
Leucorrhaea. Whites. Bee page BIB 

Liquor sanguinis. The fluid part of the blood, holding in solution flbrinc, albumen, etc. 
Livor. '1 he LT.nt assimilating gland of the body. It is situated below the diaphragm or 

midriff, and above the stomach, bowels, and kidney, and extends from the base of the 

chest to th" spine, and from side to side. 
Lobe, a rounded, projecting part. 

Loins. The small of the back, between the ribs and pelvis. 
Lungs. Two organR situated in the chest, (me on each side, with the heart between ; 

tin* organs of respiration. 



MEDICAL DICTIONARY. 21 

Lymph, lymphatic The fluid secretion of the lymphatic glands, which is emptied into 
the circulation. 

MACKINTOSH. Cloth covered with waterproof material. 
Malaria. Poisoning emanations in the air, producing disease. 
Mammary gland. The female breast. 
Mastication. Chewing the food. 

Masturbation. Personal excitement of the sexual organs. 
Median line. An imaginary line dividing the body into the right and left side. 
Medulla oblongata. An organ, marrow-like, lying at the base of the skull. 
Medullary. Pertaining to the marrow. 
Membrane, membranous. A thin, web-like structure covering parts and organs, and 

lining cavities. 
Meninges. Coverings of the brain and spinal cord. 

Mensis, menses. The monthly uterine flow during the middle age of women. 
Menstrual. Pertaining to the monthly flow. 

Mesentery. The folds of the peritoneum which hold the intestines in place. 
Metamorphosis. Transformation. 
Metastasis. Change in the seat of a disease. 

Miasm, miasmatic. The germs of disease floating in the air, which produce infection. 
Microscope. An instrument for magnifying minute objects. 
Micturate. To evactuate the bladder. 

Molar teeth. The sixth, seventh, and eighth teeth from the centre of the lips. 
Molecule. A little portion of any body. 
Morbid. Diseased. 
Motor. Moving. 

Mucilages. The gummy principle of plants. 
Mucoid. Like mucus. 
Mucus, mucous. A viscid fluid, which in health keeps the membranes in their proper 

condition. 
Myopic. Near-sighted. 

NARCOTIC. A stupefying remedy ; in large doses destroying life. 
Nausea. SicKness at the stomach ; ineffectual effort to vomit. 
Navel. The round scar at the centre of the abdomen, marking the place of attachment 

of the cord previous to and at birth. 
Neuralgia. Nerve-pain. See page 338. 
Neurine. The substance of which the brain is composed. 

Nitrogen, nitrogenous. The gas constituting four-fifths of the volume of the atmosphere. 
Noxious. Poisonous; harmful. 

Nucleus, nuclei. The germinal point in a cell ; kernel. 
Nutrition. Increasing in growth, or supplying the materials for growth. 

OBCORDATE. Half egg-shape and half heart-shape. 
Obesity. Excessively fat. 
CEsophagus. The food-passage from the throat to the stomach. 
GBstruation. Periodical sexual desire ; heat. 
Oleaginous. Oily. 
Ophthalmoscope. An instrument for examining the interior of the eye by concentrated 

and reflected light. 
Optic nerve. The nerve conveying visual impressions from the eye to the brain. 
Osmosis. Attraction of fluids for each other through moist membranes and their 

motion. 
Ossicles. Little bones. 

Ounce. One-sixteenth of a pound ; in fluids, eight drams or teaspoonfuls. 
Oxygen. The gas constituting one-fifth the volume of the atmosphere. It supports 

combustion. 

PAD. A folded cloth used as a support. 
Palate. Roof of the mouth. 
Palatine arch. The arch, in the rear of the mouth, formed by the palate bone. 
Palsy. Loss of sensation or motion, or both ; paralysis, j 



22 GLOSSARY. 

Pancreas, pancreatic juice. A large gland in the abdomen, beneath and behind the 
stomach. Its secretion. 

Papillae. Little raised points upon the surface ; they can be 6een upon the tongue. 

Papulose, papular. With dry pimples. 

Paralysis. To lose the power of motion in a part, or sensation, or both. 

Parasites. Animals or plants that subsist upon others. 

Parenchyma The texture of organs like the liver, kidneys, etc. 

Parotid gland. A gland at the angle of the lower jaw, which secretes saliva and dis- 
charges it by a short tube upon the cheek near an upper molar (back) tooth. 

Paroxysm. The period of more aggravated symptoms, following an interval of compar- 
ative freedom. 

Parturition. Childbirth. 

Pathology. That department of medical science whose object is the knowledge of disease. 

Pelvis. The bony structure at the termination of the spine, enveloping and protecting 
the lower intestines, bladder, genitals, etc. 

Pentandria Monogynia. A name given to a class of plants having five stamens and one 
style. 

Percussion. Striking with the finger-tips to discover by the resonance the condition of 
internal parts. 

Perineum. The part between the genitals and the anus or tip of the spine. 

Periodicity. Occurring at regular periods, as a chill every other day, etc. 

Periosteum. The tough membrane covering all bones. 

Peristaltic. The peculiar motion of the intestines which propels its contents forward, 
somewhat like the crawling of a worm. 

Peritoneum. The membrane lining the abdominal walls and covering the intestines. 

Petaloid. Resembling a leaf-stock. 

Petals. The colored leaves of a flower. 

Pharmacist, pharmaceutist. One who manufactures drugs. 

Pharmacy. The manufacture of drugs. 

Pharynx. The posterior portion of the cavity of the mouth, behind the palate, above the 
wind-pipe and gullet. The breath and food pass through it. 

Phosphorus, phosphates. A substance familiar to us in matches. It is a constituent 
of the brain and nerves. 

Phrenic nerve. The respiratory nerve. It arises in the neck, passes through it and the 
chest, and is mainly distributed to the diaphragm. 

Physiology. The functions of the organs of the body ; the phenomena of life. 

Pile-compressor. An instrument supporting the rectum and anus. 

Placenta. A fleshy body attached to the womb and by a cord to the child, supplying blood 
and nourishment before birth. 

Plasma The fluid portion of the blood holding in solution fibrine, albumen, etc. 

Plastic. Formative. 

Plethora. Abounding in blood ; full-blooded. 

Pleura. A wetted membrane lining the walls of the chest and covering the outer surface 
of the lung. There are two. 

Plexus. A net-work of blood-vessels or nerves. 

Pneumogastric nerve. The great nerve distributed to the chest and 6tomach. 

Polypus. A kind of tumor. 

Post-mortem. After death. 

Prepuce. The prolonged skin of the penis which covers the glans or head. 

Probang. A whalebone rod with a sponge on one end. 

Probe. A wire for examining wounds, canals, etc. 

Prophylactic. Preventive. 

Prostate gland. A gland at the upper portion of the urethra surrounding it and touch- 
ing the bladder. 

Psoas muscle. The preat muscle which draws the thigh up to the abdomen. 

Puberty. That period of life, about the age of 13, when the procreative organs most 
rap;<lly develop ; hair grows about them and upon the face of the male, the breasts 
of the femnle enlarge, and. in fact, the period of youth has passed apd that of man- 
hood or womanhood arrived. 

Pubic bone. A hone In the lower abdomen immediately under that part of the surface 
covered with hair. 

Pulse. See j. life M. 

PupiL The circular openinp in the colored part of the eye (iriB). 
Purgative. A medicine causing free alvine discharges. 



MEDICAL DICTIONARY. 33 

Pus. Matter discharged from inflamed tissue. 
Pustules. Mattery pimples. 

REOEPTAOULUM OHYLI. A hollow organ for holding chyle. 
Rectum, rectal. That portion of the bowels nearest the outlet. 
Recuperate. To regain health and strength. 
Regurgitate. To flow backward. 
Remission. Decrease in fever. 
Renal. Pertaining to the kidney. 
Respiration. Breathing. 
Retching. Ineffectual effort to vomit. 
Retina. The lining to the eye. 

Revulsive. Agents which create diseased action on the surface to relieve internal disorder. 
Roborant. Strengthening; tonic. 
U, recipe. Take the articles following. 

SACCHARINE. Of the nature of sugar. 
Saliva. One of the digestive fluids which is mixed with the food during mastication. 

Sanitarium. A remedial institute. 

Schneiderian membrane. The lining of the nasal cavity. 

Scrofulous. Of the nature of scrofula. 

Scrotum. The skin covering the testicles. 

Sebaceous. A name given to the oil-glands of the skin. 

Secernent. Secreting. 

Secrete, secretion. Drawing out fluids from the blood ; each gland absorbs material pe- 
culiar to itself. 

Sedatives. Remedies which control or depress excessive vital action. 

Self-pollution. Personal excitement of the sexual organs. 

Semen. The fecundating fluid of the male which is secreted by the testicles. 

Seminal Pertaining to semen or sperm. 

Sensorium. The centre of sensations. 

Sepals. The leaves of the envelope of a flower. 

Serum, serous. The watory portion of animal fluids. 

Sigmoid flexure. A bend in the intestines just above the rectum. 

Sinapism. An irritating plaster. 

Sound. A solid rod, catheter shape. 

Spasms. Violent and involuntary muscular movements. 

Specific disease. Syphilitic di.-eases ; pi-ivate diseases. 

Speculum. An instrument for dilating the orifice to internal canals or cavities. 

Spermatic. Pertaining to sperm or the organs of generation. 

Spermatic cord. A cord consisting of blood-vessels, nerves, and the canal of the sperm, 
which supports the testicle. 

Spermatozoa. The formative agents in generation found in the semen of the male. 

Sphincter. A round muscle closing an outlet. 

Spicula. A splinter of bone. 

Spleen. A spongy organ situated deep in the upper abdomen, between the kidney and 
stomach. 

Sputa. Expectorated matter. 

Squamous. Scaly. 

Stercoraceous. Excrementitious. 

Sternutatives. Remedies which provoke sneezing. 

Stethoscope. See illustration, page 461. 

Sthenic. Possessing excessive strength. 

Stun. Unconsciousness produced by a blow or fall. 

Stupor. Diminished sensibility or exercise of the intellectual faculties. 

Styptic. Arresting hemorrhage ; astringent. 

Sublingual gland. A salivary gland under the tongue. 

Sudoriferous. A name given to the sweat-glands of the skin. 

Suppository. A semi-solid medicine deposited in the rectum. 

Suppurate. To discharge matter or pus. 

Suspensory bandage. See illustrations, pages 317 and 562. 

Sympathetic nerves. The nervous system of the automatic functions. 

Symptom. A sign of disease. 

Syncope. Fainting. 



24 GLOSSARY. 

TAMPON. A plug made of lint or cotton. 
Tapping. Drawing off fluids in cavities by puncturing the surface. 
Tenesmus. Violent contractions. 
Testes. The male organs contained in the scrotum. 
Testicles. Testes. 

Tetanus. Permanent contraction of muscles. 
Therapeutics. The department of medical science concerned in the treatment of difl- 

Thoracic. Pertaining to the chest. 
Thyroid glands. Throat-glands. 
Tissues. The anatomical elements of organs. 
Tonics. Remedies which improve the health and strength. 
Tonsil. A gland at the side of the throat near the soft palate. 
Toxic. Poisonous. 

Trachea. That part of the windpipe between the larynx or vocal crganB and the bron- 
chial tubes. 
Traumatic. Pertaining to a wound- 
Tubercle. Concretions of degenerated matter. See page 461. 
Tubule. A little tube or canal. 

Tympanitic. Having a drum-like sound from the accumulation of air. 
Tympanum. The drum of the ear. 

ULCER, ulceration, A chronic 6ore situated in the Boft parts. A diseased action re- 
sulting in ulcer. 
Umbilicus. The navel. 
Uraemia Pertaining to urine. 
Urea. A constituent of urine. 

Ureters. The canals, two in number, carrying the urine from the kidneys to the bladder. 
Urethra. The canal or pipe leading from the bladder for the conveyance of urine from 

the body. 
Uric acid. A constituent of urine ; in excess it forms combinations, producing calculus 

or stone. 
Urine. The secretion of the kidneys which collects in the bladder and is discharged 

through the urethra. 
Uterus. An organ situated between the bladder and rectum and above the vagina, 

which holds the foetus during gestation. 
Uvula. A fleshy organ hanging from the centre of the soft palate. 

■\7ACCTNE. Pertaining to small-pox. 

v Vagina. The canal, five or six inches in length, leading to the uterus or womb. 
Varicose. Pertaining to a dilated vein. 
Vascular. Full of blood-vessels. 

Vaso- motor. Affecting vessels by reflex nervous action. 

Vein. A blood-vessel which, with one exception, carries the blue or venous blood. 
Ventricle. A chamber in the heart. 
Vertigo. Dizzinesn. 
Vesicle. A bladder-like sac. 
Vesicular. Full of little vessels. 
Vicarious. In place of another ; a function performed through other than the natural 

channels. 
Virus. The jx.ison transmitting infectious disease. 
Viscus, viscera. An <-r^an of the body. Organs. 
Vitality. The vital principle. 
Void. To < vncicitc. 
Vomiting. Emptying the stomach upward. 

ATER-BRASH. A profuse flow of saliva. 
Womb. An organ situated between the bladder and rectum and above the va- 

K'ina, which holds the foetal during gestation. 

T-OON, zoa. Animal. Animals. 

*-' Zymotic. Epidemic and contagious. 



W 



PHYSIOLOGY; 

OR, 

THE FUNCTIONS OF THE BODY. 

THE PHENOMENA OF LIFE, 



WHAT EVEEY ONE SHOULD ENOW". 



The physical life is constituted by the union of the vital principle 
with the organic structure. We are "fearfully and wonderfully 
made." The body is made up of tissues of organs, each of which 
has a distinct source of power, from which alone it may derive its 
ability to perform its peculiar functions. 

The vital properties have their origin in the ganglionic system of 
nerves, combined with the lower brain and spinal marrow. Right 
over the stomach, the principal of them all, the semi-lunar ganglion, 
holds sway, receives impressions, and gives forth energy to the vari- 
ous parts. There is a nervous channel to each division, which sup- 
plies it, having no intercommunication with other channels. The 
energy never moves backward, but goes on to its place, is there ex- 
pended, and succeeded by new relays. 

By virtue of operating different kinds of the bodily apparatus, a 
great variety of functions are performed. By one force saliva is se- 



26 PHYSIOLOGY. 

ere ted; by another, gastric juice ; by another, bile, and so on. . Thus, 
in voluntary moving of the muscles, the vital forces have a variety 
of operations. The fibres are charged with power from one set of 
I ) give them ability to act. This endows the muscle with 
the simple power of contracting, and with this simple endowment, 
it would spend its energies in spasmodic action. But as though to 
prevent this and make the muscle serviceable, there is a second set 
of nerves which holds it in subjection to the will of the individual. 
It, however, requires another nerve after this, to carry ihe mandates 
of the will into effect. Besides, there must be nerves of sensibility 
to give them the power to feel. There must also be regular tele- 
graphic communication between the nerves and the common senso- 
ri'im. Thus there are five distinct sets for every muscle that moves 
in obedience to the will. One, to empower it to act ; the second, to 
control it, so that it may be directed by the will ; the third, to se- 
cure obedience to the will ; the fourth, to impart to it the sense of 
feeling ; and the fifth, to maintain communication with the central 
authority. For example, if the arm is supplied with power in full 
force, the muscles are ready to act, whether regularly or spasmodic- 
ally. If the supply of force is scanty, the action will be feeble ; if 
it is entirely cut off, the arm is paralyzed and cannot move. If the 
second set is in full force, the muscular action, whether strong or 
feeble, will be perfectly controlled and regular ; but in case that 
there is no muscular power to be controlled, the office of these nerves 
is rendered of no account. When the third set is interrupted in ac- 
tion, the arm will move or rest at its own option. Paralysis of the 
fourth set will deprive it of the sense of feeling, so that it may be 
pinched, pricked or cut without sensation. If the fifth set, the tele- 
graphic nerves, are cut or rendered powerless, the arm may have a 
sensibility of its own, may wince or twitch when injured; but the 
action of the will can do nothing directly for its relief. 

Many of these nerves are convoluted : i.e., they are woundup in 
themselves, and bo form misses resembling brain, and doubtless 
have such function to a certain degree. These masses are the 



RESERVE FORCE. 27 

ganglia, or knots, and are generally numerous in the neighborhood 
of the most important org ms. ' They are repositories of force for the 
parts of the body to which they relate. To what extent they elabo- 
rate that force we. can only guess. We know this much — that every 
cell, nucleus and molecule has a vitality peculiar to itself, enabling 
it to maintain its own existence and carry on its specific office. The 
same thing is true again of each tissue and organ. But the mere 
concurrent action of these does not serve the purpose. There is a 
central power to attract them and enable them to act as one. It is 
the sup ort of them all. It has its own material, whatever this may 
be, to work up. It does not depend on the nutritive function for this; 
nor, indeed, very much for its organic sustentatiou. It is always in 
operation by night and day, whether the person is sick or well, 
awake or asleep, busy or inactive. 

While each organ and group of organs has its own source of power 
to supply itself, the essential organs have a common power to impart 
to their aid, especially in case of emergency. We call this the 
reserve force. It is transmitted through the body to its most im- 
portant organs, by means of the great sympathetic or ganglionic nerve. 
We find it necessary, therefore, as physicians and pathologists, to 
explore critically the constitution and offices of this most essential 
element of the bodily structure. 

We do not belong to that school of thinkers who extol the poten- 
tiality of matter on purpose to exhibit the nothingness of G-od. The 
Universe is dead without its Divine Orderer. The sensitive plate 
called Nature, can display no image except one has been impressed 
there. There can be no development or evolution of anything which 
has not been involved and inspired. We may not care to go to the 
extent of blind supernaturalists, and yield a superstitious cre- 
dence to what they assert. We may refuse to acknowledge the 
existence of secrets that we are not at liberty to explore. We mny 
demand a view of the Light and deny our homage to the thick 
Darkness. But we will steer clear of the servile credulity of disbelief. 
Because we do not see Ged with our eyes, we will not deny his 



28 PHYSIOLOGY. 

existence. Because we have not ken or mental power to solve the 
enigmas about us, we will not be so arrogant as to deny them. We 
do not admire a creed so brief as one must be which includes only 
what we understand. The science which would eliminate the 
interior spirit from man, and God from the universe, is to our 
comprehension frightfully inexact. We care not who are its 
apostles, who assume to be its votaries. They are not, for all their 
intricate learning, any whit bhort of being stupendous ignoramuses. 
At every step they exhibit their laborious efforts at stultification. 
Reasoning a Deity out of existence, they find at every turn that they 
have only substituted the Unknowable for the Unknown God. 

The essential principle of life is a positive entity, transmitted 
through the medium of the nerves, but is not created or evolved by 
them. Its elaboration is, in a very great degree, independent of the 
functions of the body. We abound with examples of illness or 
impaired health, attended with extreme debility and entire suspension 
of the nutritive function for a considerable length of time, where 
the patient, nevertheless, has recovered. Multitudes of cases of 
apparent death illustrate the same fact. Persons have died, to all 
appearance, become cold and stiff, been shrouded for burial and laid 
in the coffin, who, after a period of hours and even days, have come 
to life, and even recovered health. We often do not know when the 
dead have become so, and beyond reasonable doubt bury persons 
that might have survived. Many very intelligent men, who have 
critically investigated this matter, give very careful instructions about 
the'r own bodies after decease. 

In other countries, persons have exhibited the remarkable power 
ending animation and remaining apparently dea I for months. 
S me were aide by voluntary effort to recover vital warmth, while 
Others required adventitious aid. Animals clo the same thing, 
hibernating for long periods, and doubtless there is a like rapa-ity 
in human beings. When the vital power can call up and put 
forth energy sufficient, it will overcome any amount of apparent 
death. The Chemical affinities which are destructive only to the 



VITAL PRINCIPLE. 29 

tissues, are compelled to hold back while the potential force exists to 
control. 

In the building up and support of the body there are two functions 
always co-ordinate, the plastic and decomposing. The very mole- 
cules are Mstogenetic and histotypic. There is a general decomposing 
force in the body from the beginning of life till its close. The 
function of nutrition, consisting of the digestive and secreting 
system, is in constant operation to build up and sustain the body, 
while the absorptive and excretive system is as constantly taking 
away that which is effete. The perfection of the whole health and 
normality depend upon the activity of both functions. Under the 
constant wear, some portion of every organ is rendered unfit for its 
place, which is then likely to impede the healthful action of the rest. 
But, under the normal operation of the physiological law, no 
sooner does a particle of matter become unfit for its place than 
it is caught up by an absorbent, thrown into the general mass 
of circulating fluids, and passed out of the body by the most con- 
venient emunctory. At the same time, another particle of the 
same size, form and character is prepared by the nearest secretory 
vessel, put in its place and endowed with vitality, thus becoming a 
constituent part of the living body. In this way, the sound body 
will long retain its identity of size, form, weight and complexion, 
while all the time its component parts are undergoing rapid and 
unceasing changes. The most firm and permanent parts are thus 
wrought over once every seven years ; and the less permanent are 
renewed in as many months. The wonderful facility with which this 
is done surpasses common marvel. 

But in all this there are really no antagonistic functions in conflict. 
The vital principle that lies back of all organism provides for the 
one as well as the other. They act by pre-established harmony. 
The chemical affinities are employed just so much as convenience 
may require. " Nature" turns these forces to account, undoubtedly ; 
but does not depend upon them for the supply and regulation of 
animal heat. Hence heat is often elaborated when the health is 



30 PIIYSIOLOGY. 

impaired, without oxygen or combustible substance. While she has 
supreme control, she tolerates no rival. She is often crippled, but 
even then she admits no joint participation of power. It is all 
vitality while there is vitality, and when that ceases all is chemical 
affinity. 

This vital activity does not arise from the mutual action of oxygen 
and the elements of the food. Perhaps, if it did. men might obviate 
the final dissolution. The fact that has been cited of persons lying 
for days and weeks without food, or using only the slightest amount, 
shows that "man does not live b}' bread alone." There is some other 
source than a chemical process. In these Cases of suspended anima- 
tion, where there is to be resuscitation, every part of the body must 
be kept constantly supplied with enough of the living principle to 
ward off the destructive action of chemical affinity ami to restore the 
suspended powers. No person is dead till these powers cease to 
operate and the body begins to decay. "We shall do wisely to 
inquire more carefully concerning the principle of life and depend 
less upon phenomenal action. 

The mental alienation occuring in cases of debility is due to that 
cause ; and most such persons recover the possession of their reason 
before death. The brain is not disorganized, but disabled. 

In tetanus, the nerves are enfeebled or paralyzed, whose function 
is to control the muscles and keep them subject to the will. In the 
interval of relaxation, the contractile power acts, producing con- 
vulsions. They cease when the superior power resumes ascendency. 

In the vital economy, every organ and department has its own 
laws and instinctively performs whatever is necessary for its preser- 
vation. The stomach does its own work, maintaining its own 
functions and converting food into chyme. It is intelligent and 
makes its wants known. It expresses gratification when supplied 
with agreeable food, gives a signal on receiving enough, and when 
permitted, makes the best use of what it obtains. The other organs 
have their analogous powers. The laws are fixed and uniform. 
Art cannot change these or furnish substitutes. It cannot hasten the 



DISEASE. 31 

elaborating power, or augment it at any given time. When the 
stock of energy is reduced to barely what is necessary for ordinary 
use, any reduction below that amount is certain to be followed by 
disorder. "We have disease — the negative of ease. The great number 
of disorders ensuing with change of the weather and from exposure 
are to be attributed to this cause. Colds, rheumatisms and fevers 
are among the more common forms of ailment. 

There are, therefore, three forms or phases of departure from the 
condition of health — the declension of power, functional derange- 
ment, and organic derangement. 

The first of these is most common, and perhaps least noticed. A 
perfectly sound body is proof against every disease. It can, on 
every occasion, summon vital force enough to guard against injuries 
and repair damages without display of unsoundness. This is the 
normal state of man and of every animal. It would seem, however, 
as though for ages mankind had been employed in destroying such a 
condition; and hence there are, on every hand, large numbers who, 
if not actually diseased, are yet, from the low state of their vital 
powers, constantly liable to attack. There is never, there can never 
be, such a thing as excess of power. The more power any part of 
the body has, the nearer it approaches the standard of perfect health. 

It is not e isy to understand what disease is from the definitions of 
medical men. We sometimes are ready to accept the declaration of 
Magendie, the great physiological writer, that they know nothing 
about it. Certainly, French physicians seem to act from that 
standing-point, and treat invalids with regard to the power which 
they have, rather than from any medical aid they themselves are 
able to render. 

In truth, when the powers of the body are impaired, the deviation 
from healthy action is the signal of a deficiency of vital force. So 
long as there is no such thing apparent, there is no alarm, although 
the vital organs are often so injured and impaired in energy that 
•the person is on the brink of death. It is a curious fact that when 
the alarm has been raised, the anxiety and endeavor are all bestowed 



32 PHYSIOLOGY. 

to get rid of the peculiar symptoms. Yet, if an army should be 
alarmed In cause of the signal guns of its pickets, he would be 
accounted a poor general who should remove the pickets and senti- 
nels in order to allow his men tobe relieved of distressing excitement. 
Yet this is what medical men aim at, and their patients require from 
them. The treating of phenomena and symptoms constitute the 
principal part of medical practice. 

Yet many of these deviations, known as functional disease, are 
but the shifts which " Xature" employs to meet and remedy the 
difficulties which are constantly occurring in some portion or other 
of the complex physical structure, through violation of the laws of 
life. Every org in and part is liable to derangement from some 
incidental deficiency of energy. The "symptoms," as they are 
called, the external announcements of tlie defective state of affairs, 
will depend on the nature and functional character of the parts 
affected, the degree or deficiency of vital power, the nature and 
amount of force present and the operation of disturbing causes. 
These should be carefully observed by the physician, who should 
abstain from special endeavor to modify the symptoms and direct his 
attention to the renovation of the impaired forces. We may be sure 
that when this has been duly effected, the derangement will cease 
and all will go on thenceforth in its usual ord:r. The principle of 
action as will be seen, is very simple ; the skill and experience of the 
physician are required for its application. 

Take such a disorder as epilepsy. There is impairment of the 
interior portion of the brain. This results in a draft for power 
on those parts involving the large blood-vessels. They are enfeebled, 
and the blood, congesting in them, presses on the brain and prevents 
the free egress of nervous influence. This causes the fit. Directly 
afterward the fonts arc remanded again to the large vessels and the 
blood removed, which suspends the fit. But, the repair not having 
been made, there is another draft made and a return of the tit. This 
will li«- repeated till the individual is restored to health, or the 
difficulty rendered insurmountable, in which latter case death 



STRUCTURAL DISEASE. 33 

supervenes. Sometimes the fits have recurred more and more 
frequently, till apoplexy ensued ; and this was followed by a more 
complete state of health. Such having been the case, we can easily 
perceive how much judgment is required in the way of permitting a 
reparative operation its legitimate sphere, and to abstain from too 
much effort to impede or divert. 

When the recuperative operation of an organ is not ample for the 
removal of the effete matter and the supplying with new material, 
there is a change of structure. Even in functional disease there is 
more or less of this, but as it is only temporary it is not regarded. 
When, however, the change has become permanent, it is styled 
organic disease. The liver, heart and glands are all more or less . 
affected in this way. 

We perceive from this, that so long as the body is in full vigor, no 
part will take on disordered action. The energies must be reduced 
to a certain point ; as soon as they recover, the derangement will 
cease. If, however, the derangement of functional action is pro- 
longed to a certain degree, structural derangement is the result. 

The return to health must take place by the retracing of the way 
by which it was lost. Organic or structural disease is not always 
or often the harbinger of death ; and the same thing is true of func- 
tional derangement. When the important organs become deficient 
in vitality, they will yield, and the person die, before there is time 
for morbid change of function or substance. Even where lesions 
exist, they are the effects, not causes, of trouble. Though they occa- 
sion death, this is none the less true. It is not scientific treatment to 
deal with such matters and to disregard the conditions which caused 
such a manifestation. 

In a sound constitution, where there is strict obedience to the laws 
of life, the whole organism will be kept in good condition, leaving a 
margin to meet all extraordinary demands on the vital forces. But, 
unfortunately, these examples are not numerous. There is a great 
deal of vital machinery more or less enfeebled, which is liable to de- 
rangement from any unusual demand or pressure of that kind. To 



34 PHYSIOLOGY. 

remedy this, the general economy renovates the enfeebled parts each 
in turn, beginning on one, and then taking another, till the whole 
have been cared for. It is of no account in this process whether 
symptoms appear to disclose the matter or its necessity ; the work 
is all the same. The pathological condition of an organ is simply 
enfeebled vitality. No organ will deviate from its natural state to 
take on diseased action while Nature is strong enough to prevent this. 

Many persons are subject to diversified forms of illness. At one 
period a cold seems to be imminent on all occasions, and the sensa- 
tion of chilliness appears almost constantly. After a period this will 
all [muss off, and there appears to be little risk, how T ever carele-s the 
•person is in the matter of exposure. The same thing is true of other 
disorders; they recur at periods, between which the person appears 
to enjoy every immunity. "When any part of the machinery has been 
thus thoroughly put in order, it will so remain till it has been com- 
pelled to part with a large share of this stocu. of nervous energy. 

Owing to this rotary system of repairing the body by renovating 
the several parts in turn, there are seldom two diseases found in the 
sime individual at one time. But for this, several important organs 
might fall into disorder at the same time, and embarrass, if not en- 
danger, life. 

In fact, there is a general renovating work going on from the be- 
ginning of life to its close. In a perfect state of health, the repair 
will keep pace with the wear. Generally it is far enough in advance 
to permit no apparent disorder, no symptoms; but there is a state, 
which is strictly pathological, in w T hich persons tire easily. When 
Mr re are actual violations of the laws of life, or unwholesome con- 
ditions beyond our control, so that functional derangement is un- 
avoidable, Nature arrests it as speedily as possible, and restores the 
functional condition of the parts to some point above what is regarded 
as actual disease. 

The processes essential to life, and its varied manifestations, are 
those of nutrition and secretion. By these the body acquires its force 



FOOD ELEMENTS. 35 

and performs normally its functions. Mere adding to the bulk of 
the body is an imperfect idea of the matter. The process is com- 
plex. Not only are digestion and a-similation comprehended, but 
likewise the circulation of the blood, respiration, secretion, excretion. 
We must regard them as a whole to obtain a fair idea of the whole 
matter. For example, digestion and assimilation are not only de- 
pendent on the food as to its quantity and quality, but upon the 
circulation, the respiration, which imparts the vital air, secretion, ** 
which separates the nutritive parts and elaborates them for their 
place in the structure, and excretion, which removes from the body 
those parts that have served their purpose. 

By regarding this function in this manner the medical practitioner 
is enabled to arrive with more precision and exactness at the solution 
of those complications which he constantly encounters in diseases. 
He perceives that impaired nutrition should be treated by an en- 
deavor to enable the deranged processes to return to their healthy 
state in the order in which they were deranged. 

All foods are constituted of the elements carbon, hydrogen, oxy- 
gen and nitrogen, combined with certain mineral bases. As they are 
designed to replace effete elements in the body, they must contain 
like constituents. The quantity is principally regulated by the 
amount of air we breathe. In the endeavor to ascertain the best 
varieties required for supplying the waste of the body, we must re- 
gard the chemical elements which are a part of the constitution, the 
mode in which these are combined to form tissues and organs, the 
atmosphere which surrounds, the waste and the structure itself. 
Thus, in the human body certain albuminous, fatty and mineral 
principles are required. The albuminous are the substances abound- 
ing with nitrogen; the fatty are those fats or other compounds which 
are readily resolvable into fat ; the mineral are principally phosphate 
of lime and chloride of sodium. Every kind of nutritive food must 
contain these three principles. Experiments have been made with 
the separate elements, always resulting in starvation. Sugar, oil 
and gum ls a sole diet will produce death in a dog in 33 days; white 



I 



36 PHYSIOLOGY. 

bread will starve in about 50 days; cheese and white of egg will sup- 
port life a little longer. 

Mere nitrogenous food will not answer, as Liebig and other chem- 
ists seem to imagine. To form tissue requires that these be trans- 
formed into albumen and oil, so as to produce the molecules of the 
chyle from which the blood-cells are formed. All the elements 
exist in every tissue; but the fibrous tissues abound in albumen, the 
glandular organs in fatty, and the bones in mineral matter. All 
recent researches have indicated the great importance of the fatty 
constituents. The brain, the bones, as well as the soft fibres, are 
imperfect without them. 

More food is required when the oxygen in the atmosphere is abun- 
dant. When cold and condensed, more oxygen will unite with the 
tissues of the body. Essential as this element is to the whole of our 
active life, it is so solely from its influence to bring the latent forces 
into activity, and so to waste the tissues of which the body is consti- 
tuted. This waste creates the necessity for food. In warm weather, 
or in warm rooms where the oxygen is rarefied, less food is wanted. 

Exercise also causes waste of tissue, partly from the wear of parts, 
and partly from the increased breathing required in case of muscular 
exertion. Active men, therefore, require more food than those who 
lead idle lives. It is computed that a laborer requires '35 ounces of 
dry, nutritious food daily. Sedentary people subsist upoh less, but 
they are weak in fibre, and generally valetudinarians. About five 
pounds of the food daily eaten consists of water. 

Chemistry, with all the endeavor to explain physiology and pathol- 
ogy, ii Incapable of being carried further. It cannot approximate 
any solution of a vital' law or principle. All living beings are gov- 
erned in their selection of food by laws essentially connected with 
Structure, but out of the power of the chemist to elucidate. For 
example, vegetable albumen and animal albumen are essentially alike, 
b,it some animals ran subsist onlj' upon the one and some on the 
other. The carniveru reject vegetable food, and the gramuivora will 



HIBERNATION. 37 

not eat flesh. Substances which contain little nutriment for one 
order of creatures are the chief food for others. 

Another fact greatly overlooked is the necessity of an agreeable 
flavor to make food nutritious to the fullest extent. Where there is 
no taste, or a disagreeable one, the saliva will fail of being secreted, 
and imperfect digestion is certain to ensue. Of all causes of disease, 
irregularity in diet is the most common. As a corollary, proper 
attention to food is the most certain means of cure. 

A curious fact is noticeable in the various kinds of animals — that 
of hibernation. At the approach of cold weather they cease to eat, 
breathe little, and exist in a torpid state till winter is past. Singular 
stories are also related of men having passed through similar periods, 
dormant and insensible, or partially so, often likely to be mistaken as 
dead and buried accordingly. These statements have been ques- 
tioned, but chiefly by that class of persons who superciliously reject 
everything which they happ n not to understand. "We have seen it 
suggested, and that with great plausibility, that hibernation had 
once been a peculiarity of certain human famili.s. Living in caves 
and dark apartments, their blood was deficient in many of the ele- 
ments necessary to high vitality. They easily became dormant and 
cataleptic. They breathed little, had feeble circulation and sensi- 
bility. We can understand from this not only the marvellous tales 
of fakirs and jugglers, but the stories of the prodigious powers of 
endurance which have descended to us from former periods. 

Under ordinary conditions, however, complete abstinence from 
food cannot be sustained longer than eight or ten days. In a moist 
atmosphere this time can be prolonged a little ; but that is all. 

The whole nutritive process is easily comprehended. The food is 
broken down in the mouth by the action of the teeth, jaws and 
tongue. It is at the same time moistened by the saliva. This opera- 
tion is of imperative necessity, to fit it for further digestion. Starch 
is made sugar, and other constituents are materially changed in 
nature and properties. But a truce to chemical changes. The real 
transmutation is the appropriation, the reception of the aliment as a 



38 PHYSIOLOGY. 

constituent of the body. The saliva from the parotid glands per- 
meates the food through and through; that from the submaxillary 
glands is magnetic in character and communicates the peculiar vital 
principle, while we at the same time recognize it as taste; and that 
from the sublingual and palatine glands is a viscous matter which 
surrounds the masses of food, but does not enter therein. 

The action of the nerves which communicatj with the mouth 
largely controls the salivary secretion. Mental emotion will some- 
times arrest it altogether. Attractive food largely increases the 
quantity. A fit of anger will cause a portion of the iron of the blood 
to pass into the saliva, giving a strong metallic taste. 

The more thoroughly the food is broken in the mouth, the better 
prepared it is for the action of the stom .ch. Rapid eating is a com- 
mon cause of indigestion. The peculiar condition of the teeth is a 
secondary agent in the matter. The loss of a tooth is a misfortune. 
It obstructs mastication aid contributes its share to a host of other 
His, which compel a resort to the physician. 

The food, having been transformed by mastication and insaliva- 
tion into an alimentary bolus, is carried by a spontaneous, half- 
automatic motion of the tongue and neighboring parts of the mouth, 
to the pharynx and the oesophagus, or gul ! et, by which it is proi elled 
speedily to the stomach- The propelling action is denominated 
dhixtaltir. The upper opening of the stomach, termed the cardiac 
orifice, opens and admits the bolus. Immediately a commotion 
begins all through that organ. It moves like a crawling animal, and 
so brings the food into contact with its interior surface. Meanwhile, 
the interior membrane at every contact sheds out the gastric juice, in 
greater or less quantity, as the food his been more or less thoroughly 
insalivated. It possesses extraordinary solvent properties, especially 
upon albuminous substances. About fourteen pounds of this solvent, 
are daily secreted and employed, and about tliree and a half of saliva. 
The vermicular motions of the stomach, as they are called, are con- 
tinue d till the entire contents are reduced to a semi -liquid mass, 
denominated chyme. It requires but a thought to perceive the im- 






DIGESTION. 89 

portance of thoroughly masticating the food, and not assigning that 
labor also to the stomach. The chyme, as fast as it is prepared, is 
passed from the stomach through the pyloric orifice. During the 
process of trituration in the stomach, that organ retains its contents 
with great tenacity, so that only the finest of the chyme will pass 
through; but the process once over, undigested masses will be ex- 
pelled. The observations of Dr. Beaumont upon the stomach of 
St. Martin, the Canadian, have constituted the source from which 
many conclusions have been drawn. 

It appears that the vermicular motion of the stomach is principally 
necessary for the perfect digestion of vegetable matter, flesh having 
been placed in metallic balls and thoroughly digested without the 
trituration. It is reasonably certain that the movements of the stom- 
ach are not necessary. Numerous experiments have been made with 
gastric juice outside the stomach, but it requires three or four times 
as long a period. We explain this on the supposition that the 
nervous influence is withheld which that organ possesses, and which 
is, though intangible, an important factor in the matter of digestion. 
The condition of the mind certainly influences the process as well as 
the period of life. 

The stomach is not a simple organ, but highly complex. It is full 
of folds and convolutions, minute quadrangular cellular divisions, 
each of which can justly be regarded as no less than a little stomach 
which acts, in a measure, distinctly by itself. Every operation, there- 
fore, of the entire organ, or viscus, is the result of the combined and 
manifold agencies of these minute stomachs, which really perform 
the more perfect work to which it is assigned. 

A considerable portion of the elements taken into the stomach as 
food are absorbed from it by the different vessels set apart to that 
office. Fluid matters and the more refined constituents of the food 
are carried at once into the veins. The epithelial coat absorbs large 
portions, carrying it to the lymphatic vessels which abound there so 
largely and transmitting it to the mesentery and the receptaculum 
chyli. Other material which requires further purification is taken by 



40 PHYSIOLOGY. 

the gastric veins and transmitted to the liver. According to the old 
physiologists, the more important essentials of digestion were thus 
performed. 

A sect of yogis, or ascetics, in Hindostan, regarding excrementation 
as a vile function to be avoided, have the practice of regurgitating or 
vomiting up their food, before any of it should have passed from the 
stomach into the intestines. We can pass no judgment on the tone 
and exaltation of the peculiar sanctity thus acquired; but they suc- 
ceed in escaping the act of defecation. 

The further process of digestion is conducted in the intestines. A 
morbid squcamishness sometimes precludes these from being men- 
tioned, but their processes are the more essential to growth, health 
and the whole economy of life. The small intestine leaves the stom- 
ach at the pylorus, and extends from 15 to 13 feet, enfolded in the 
mesentery and occupying the middle of the abdomen. It is usually 
spoken of as three — the duodenum, the jejun um and the ileum. There 
is no marked line of division between them. It is lined with mucous 
membrane, abounding with vessels which are full during the diges- 
tive process. This lining membrane is also full of folds or duplica- 
tions, so numerous as to render the length of the membrane twice as 
long as the tube itself. Vessels, nerves and lymphatic glands are 
found between the folds. This arrangement enables the contents of 
the intestine to come into contact with a greater extent of surface, 
thus tendering digestion land the absorption more thorough. 

When the chyme leaves the stomach it becomes mixed with the 
bile and pancreatic juice, the one a secretion of the liver and the 
other of the pancreas, a gland back of the stomach. A great deal of 
research baa been expended upon the office of these fluids. That the 
bile is excrementitious has become generally acknowledged. It con- 
sists of matter separated and elaborated by the liver from the blood 
of the portal vein-, and one element which it contains, cholesterine, 
Is almost purely refuse. It is sometimes thrown into the blood, and 
there creates disease of a marked character. It has been supposed 
that the office of the bile in digestion is confined to the action of the 



BILIARY FUNCTIONS 41 

biliary salts and its saponifying functions. It has also been supposed 
to regulate the peristaltic action of the intestine. Certainly it arrests 
the tendency to putrefaction. The contents of the bowels speedily 
become of a most offensive character where the bile is defective in 
character or quantity. Many of the prevalent diarrhoeas, dysenteries 
and other affections of the bowels are characterized, if not occasioned, ' 
by this fact. Bile also facilitates the digestion of fats; and both per- 
sons and animals more or less disordered in regard to the secretion, 
it is well known, betray much repugnance to fatty foods. 

When by any accident it enters the stomach, it arrests digestion at 
once. Nausea, vomiting, loathing of animal food, and the whole 
array of symptoms known as bilious are the result. The principal 
part of the bile does not, however, become stercoraceous. It is, 
instead, taken into the blood, where it performs the office of separat- 
ing from it the effete hydrogen and ca: bonic acid. The fluid thus 
first secreted or separated is deposited in the gall-bladder and is con- 
veyed thence by the duct. As the entrance into the duodenum is 
smaller than at the beginning, there is some liability to obstruction 
from mechanical reasons or disease. Often it is easy to crowd its 
contents — a portion, at least — into the stomach by stroking the right 
side somewhat forcibly beneath the ribs. We have a great distrust 
of the medicines usually employed for the purpose of facilitating its 
flow or augmenting its quantity. 

The pancreatic juice is next entitled to notice. It is the secretion 
of the pancreas, a gland resembling the parotid in structure. Like 
the bile, saliva and gastric juice, it is principally secreted when the 
imparted stimulus from the food calls it forth. During the intervals 
secretion is suspended. It begins, however, when food first enters 
the stomach, before chyme has begun to pass into the inte-tine. Its 
virtue as a digestive agent is due to the element of pancreatine. Its 
essential use is the digestion of fats. These pass through the body 
unchanged when the gland has been exterminated. It is the only 
agent in the body capable of forming a complete and permanent 
emulsion. The greatest part of the fat which is digested in the small 



42 PHYSIOLOGY. 

intestine is simply emulsion ized, but not essentially changed in any 
other particular. Starch and other hydro-carbons are also acted 
upon by the pancreatic juice. 

Another fluid, known as the intestinal juice, participates in the 
work. This is the direct secretion from the glands in the mucous 
membrane of the intestine and has long been an enigma to physiolo- 
gists. It will digest albumen and cooked meat and change starch 
into sugar, showing that its province is to complete the function of 
digestion and to perform what the other digestive fluids will not. It 
has been found upon experiment that nutritive substances coming in 
contact with the intestinal juice alone were capable of supporting life, 
when contact with all the other digestive fluids failed of it. 

Nevertheless, each of these secretions are auxiliary. The saliva 
stimulates the secretion of the gastric juice and this in turn the flow 
of the bile, pancreatic and intestinal juices; and a permanent dis- 
turbance of either secretion is a prolific source of disease. 

During the period that the food is in the small intestine that organ 
is in constant motion, writhing and forcing its contents forward and 
backward. 3Ieanwhile the chyme by the action of the pancreatic 
and intestinal fluids is dissolved, reduced to the molecular condition 
and prepared for reconstruction or histogenesis. It is immediately 
absorbed by ebyle-vessels in the walls of the intestine. 

The residuum having parted with the digestible material is finally 
conveyed to the extremity of the ileum. Here begins the large intes- 
tine, its beginning a species of cul-de-sac. denominated the ccBCum. 
The intestine; itself is known as the colon and is from four to six feet 
long. It ascends on the right side of the body from the iliac fossa. 
From this point the intestine proceeds by the sigmoid flexure to the 
rectum 

The opening by which the small intestine communicates with the 
caecum isdenominated the ileo-csecal valve. The rejected contents of 
the ileum make their way through into the crecum and are pushed 
forward into the colon. They sometimes remain here a considerable 
time; but as a rule are carried slowly onward by the contraction of 



CONSTIPATION. 43 

the muscular fibres, till they reach the sigmoid flexure. Here they 
accumulate till the period arrives for their discharge. 

Many disorders, some of a very dangerous and even fatal character, 
arise from neglect in this matter. The fcecal substance consists of 
transformed cholestrine and the waste matters of the food ; and when 
unduly retained their now fluid parts are taken up by the coat of the 
intestine and carried into the blood, inducing a morbid and some- 
times highly dangerous condition. The more solid portions impact 
and become a hardened mass almost and sometimes entirely incap- 
able of removal. Death sometimes takes place from this cause. 

We do not countenance much tampering, however, to obviate cos- 
tive habits of the body. Good sense among intelligent physicians is 
setting itself very decidedly against that class of drugs denominated 
as if facetiously, cathartic. They confer at best but precarious bene- 
fit. The worried organ, whenever it begins to recover from the 
weakening induced in its repose, becomes more inactive than before; 
and the wretched doser having set out in his road to ruin feels him- 
self necessitated to continue his downward career. French physi- 
cians never purge and in common life the syringe has superseded the 
drastic. Here of course there may be and often is a great abuse. 
But healthy food joined with correct habits is seldom the occasion of 
constipated intestines. 

It has been remarked that the action of the digestive fluids upon 
chyme in the small intestine reduced it to a molecular condition. 
The next operation is its removal to the circulation itself. This is 
accomplished by the mucous membrane of the small intestine. Along 
a large extent, this membrane is in folds or ruga, almost double the 
extent of the intestine, thus affording an immense absorbing surface. 
A large portion of the bile as well as of the molecular elements of 
the food is thus carried away. 

The mucous membrane is covered with an infinite number of 
minute projecting points, called in technical language, villi. Over 
these is a layer of epithelial cells. The fluid contents of the intes- 
tine are absorbed through the walls of these cells by the process 



44 PHYSIOLOGY. 

called endosmosis. Each cell by a species of vital or magnetic action 
peculiar to itself elaborates and transmutes the fluid which it has 
imbibed, forming the white milky fluid, the chyle. This consists in 
a vastly preponderating degree of the fatty emulsion created by the 
action of the pancreatic juice. If there is no such emulsion from 
whatever cause, there is no chyle. No chyliferous vessels exist in 
the intestine till after the point where the pancreatic duct passes out its 
contents. It is affirmed by some writers that defective action of the 
pancreatic fluid not only renders the chyle defective but results in the 
evolution of the corpuscles or degenerate histogenetic nuclei, better 
known as tubercles. Hence an artificial pancreatic emulsion has been 
devised where there is a defective action of this character and it has 
been represented as having proved beneficial in phthisis. 

The villi of the intestine communicate with the chyle-ducts which 
pas- iiito the mesentery or investing sheath. Here it passes through 
the lymphatic glands with which that membrane is abundantly pro- 
vided. A lymphatic gland consists of a cortical and medullary por- 
tion, constituting a sac in which is a molecular fluid, numerous 
nuclei and a few cells, in all stages of development. These glands are 
diffused everywhere over the body and communicate with each other 
by lymphatic vessels. All these have valves which prevent the 
fluid from being carried except in one direction. They resemble the 
veins in their structure and character. 

The lymphatic glands retard the flow of the lymph toward the 
great trunks and blood-vessels; and morbid matters which have been 
taken up by the absorbents are frequently retained by these bodies. 
Glandular disease is hence of common occurrence ; and when from 
any cause it becomes malignant we have the various affections 
denominated cancer. 

The Lymphatic glands secrete or form the corpuscles of the blood. 

Peyer'fl glands at the very lining of the intestine begin; mesenteric 

glands, the spleen and other glands do their part in turn. The lac- 

i any the chyle from one to the other so that each 

may perform its part. In each gland the molecular fluid derives 



CIRCULATION OF BLOOD. 45 

somewhat from the neighboring "blood and the molecules continually 
aggregate together, forming the nuclei of cells. Both chylification 
and sanguification are thus completed by the action now described. 
Ultimately the incipient blood thus created is gathered into one com- 
mon receptacle and emptied into the thoracic duct. It speedily 
finds its way to the subclavian vein, the right side of the heart and 
the lungs; when by contact with oxygen it assumes the full red color 
of arterial blood. 

When the pulmonary process is not completed by diseased glands 
the globules of blood are not reddened but remain in the condition 
known as leucocythemia. The presence therefore of leucocytes in 
the blood is assurance of a hypertrophied gland. 

The circulation of the blood is not difficult to understand. It is a 
process carried on by the heart, arteries, capillaries or intermediary 
vessels and veins. In man and the higher animals there are two cir- 
culations recognized ; the systemic or greater and the pulmonary or 
lesser circulation. In the former of these, the blood is considered as 
leaving the left ventricle cf the heart, passing by the aorta through 
the systemic arteries into the capillary vessels and thence by the 
veins to the right auricle of ihe heart. The lesser circulation next 
occurs. The blood passes into the right ventricle, through the pul- 
monary artery to the capillaries of the lungs, in which it is exposed 
to the atmosphere, and then back through the pulmonary veins to 
the left auricle and ventricle, where the systemic circulation begins. 
The term circulation is also applie 1 to partial movements, as the 
portal circulation to the passage of the blood by the portal vein 
through the liver, the cranial circulation to the passage through the 
head. The nervous circulation, however, is of a nature essentially 
distinct. . • 

The contractions of the heart first propel the blood into the arteries. 
But the heart alone is not sufficient to account for the entire move- 
ment of the blood. Its mechanical force is far too little. The coats 
of the arteries are of analogous character and aid to carry the blood. 
Nevertheless, with the ramifying of the vessels and the resistance 



46 PHYSIOLOGY. 

offered by the various tubes, the force is checked- at the capillary 
system. Hence, the blood nowhere passes through an artery so rap- 
idly as it flows when leaving the heart. The vessel is at first dis- 
tended; there is an increase both of length and diameter, which is 
followed by a recoil and recovery of the previous condition. These 
changes constitute what is known as the pulse. It is felt when the 
finger slightly compresses an artery and is largely employed to aid 
in determining the character of a disorder. The volume or force 
varies, from a great variety of causes. Exercise increases the rapid- 
ity of the pulsations. AVe find them quicker in the morning than at 
evening. In health the pulse reaches its height at noon and is at its 
lowest point at midnight. It is more frequent in a standing than in 
a sitting position; and slow r er yet in the recumbent posture. The 
natural pul-c of the adult man is from GO to 70 per minute; of the 
adult woman, about ten higher. In the new-born infant it is from 
L30 to 1-10: in old age, froni 53 to GO. In disease, there are great 
deviations. It lias been k;,own to be as low as 17, as in profound 
coma, and as high as 200 a minute in hydrocephalus. We have also 
the strong and weak pulse, the full and small, hard and soft, rigid, 
tense, wiry, thready — all which have to be learned by careful observa- 
tion. 

The offices of the blood are numerous. Its circulation is essential 
to their performance. It contains the vital principle which it derives 
from the nervous system, together with the fluids and rudimentary 
elements of the corporeal structure. There is no possible formation 
in the body, of which the blood does not furnish the principles. 
During every round of the circulation these arc yielded up. The 
veins require the liquor sanguinis; the glands take what is wanted 
for preparing the various secretions; the fibres and nerves appropriate 
their bhare and the brain and ganglia draw out their peculiar spirit 
and energy. This wasting of the nutritive elements creates a con- 
dition analogous to hunger; for which nature 1 as provided, in the 
store.-, of chyle prepared from the food, and lymph secreted by the 
lymphatic glands. While these are abundant, the body performs its 



INFLUENCES OF RESPIRATION. 47 

functions without complaint. But as the supplies become low, the 
ganglionic nerves become aware of the fact and report it to the solar 
plexus, where the sensation known as hunger presently manifests 
itself. Hence, the character of the deficiency also gives a definite 
direction to the appetite, causing one or another variety of food to 
be desired, according as the want happens to be. 

The blood having parted with its essential virtues and substances 
next seeks to regain them. Forsaking the arteries and capillaries 
and taking in the contributions of the glands it makes its way as 
by its own ardor and purpose through the several veins to the great 
central duct, the vena cava, and thereby to the right auricle of the 
heart. It is now more or less nourished anew from the chyle and 
lymphs and loaded down with the dross of the body which it has col- 
lected in its journeyings. The restless asphyxiating sensation is now 
communicated to it and it rushes through the ventricle and pulmonary 
artery to the minute cells and chambers of the lungs to unload its bur- 
dens and feed itself from the vital air. 

The lungs are, after all, the rulers of the entire viscera. Every 
intestine, the stomach, liver, pancreas, spleen and the womb itsdr 
are subject to their dominion. Respiratioa calls every potency into 
motion. Life in the accepted sense of the term begins in full powe] 
with the inhalation of air. The braiu itself and the spinal cord pulsate 
and contract, keeping time with the lungs. They are the organs whicU 
open to us the spectacle of corporeal existence and furnish the theatre 
for its display. There is no part of the body which the respiration 
does not influence ; not a nerve-fibre which if does not stimulate into 
action. They drive the very fluid or spirit of the nerves into circula- 
tion. They serve also to blend the peculiar voluntary intellectual life 
of the cerebrum with the natural life of the cerebellum and medulla. 
They also receive impressions from the will; so that they give a com- 
plete representation of the dominant impulse. Anger, fury, courage, 
frenzv, fear, mercy, pride, etc., are set forth by peculiar swelling, 
drooping, sinking in or trembling of the breast, as also by the speech 
and its peculiar intonations and the expressions of the countenance. 



48 PHYSIOLOGY. 

So perfectly concurrent arc they with the brain, that one moves 
when the other moves; if the one stops the other also stands still. 
They also are the agents which impart to the nerves the function of 
:i. The holding of the breath will accordingly more or less 
paralyze the sensibility ; as also will the inhalation of hydrocarbon 
fluids. 

The inhalation of air by the lungs is denominated inspiration, the 
exhaling of it, expiration. Perspiration is the analogous function 
exercised by the skin. 

The blood having collected in the right chambers of the heart, 
heterogeneously mingled, undigested and crude, is eagerly caught by 
the lungs and carried through the artery, along the bronchi, to every 
capillary and minute subdivision. In this condition the gross and ef- 
fete portions are eliminated into the bronchi and trachea and cast from 
the lungs by expiration. The volume of the blood is reduced mate- 
rially by this subtraction; the pulmonary vein which collects it to. 
carry back to the heart, is smaller than the artery. What the lungs 
fail to remove by respiration is expectorated or carried 1o the palate. 
The inhaled air is made the vehicle to load with the effete matter for 
the purpose of conveying it from the body. In case this process is 
imperfectly performed, portions of the morbid material remain and 
fix themselves in tae tissues of the lungs. Hence the numerous dis- 
eases whicb attack those organs. 

The atmospheric air is carefully scrutinized by the various organs 
before it is suffered to enter the lungs. The papillae of the olfactory 
nerve first discuss its agrceableness or unsuitableness; welcoming it 
heartily if it bears no noxious burden, but struggling against it, and 
shutting the nostrils, if it ]s repugnant. What is admitted undergoes 
a sifting and filtration, first by the nose and afterward by the trachea. 
Every endeavor is made to free it of all impure accompaniment. 
When, finally, it reaches the lungs, it is warmed and freed of noxious 
elements The little veseicles and veins are now hungry and eager 
to obtain its nutritive principles. The blood has already put on its 
scarlet and is ready to unite with the new elements. Having done 



SUSPENDED RESPIRATION. 49 

this, the air is immediately loaded with the discarded impurities and 
driven away. 

That the air actually nourishes the blood is apparent. It is always 
more or less involved in a cloud or ocean of emanations from the 
earth, water, minerals and vegetables — some of which arc poisonous 
and others beneficial. It likewise contains the peculiar ether and 
force which the sun has imparted. The lungs and skin take them 
as food and are made vigorous by them. Hence we observe that 
sleep itself, and even ecstasy and catalepsy, are in some manner 
restoratives and sustainers of the blood. Many persons have pro- 
longed life for months, years, and even longer periods, without 
taking sustenance in any ordinary manner. Many species of animals 
hibernate, and even subsist for years in this way. The emanations 
of food will often satisfy the appetite. The witnesses to these facts 
are numerous. 

The blood, having been divested of its effete and noxious particles, 
is gathered again by the pulmonary vein and returned to the heart. 
It is now regenerated, and ready for a new career. 

If respiration is embarrassed or difficult it constitutes dyspneea. 
Its arrest constitutes asphyxia. This is the form of death produced 
by drowning or strangulation. It appears to be a general rule that 
if the air is cut off from the blood of a warm-blooded animal, all ex- 
ternal movements of the muscles wi 1 cease in from 3 to 5 minutes, 
and the circulation of the blood in ten minutes. In the recent catas- 
trophe of the steamer The Princess A lice, those who could not swim 
sank at once. The swimmers fared little better, however. The 
river Thames is the Cloaca Maxima of London, and those attempting 
to reach shore from the doomed vessel were so speedily suffocated by 
the mephitic gases from the water that they scarcely seemed to put 
forth an effort. 

Some persons have acquired the power of remaining several min- 
utes under water. The pearl-divers of the Indian Ocean will often 
remain under water and pick up oysters for o or 4 minutes. Under 
ordinary circumstances this would be sufficient to produce death; but 



50 PHYSIOLOGY. 

much depends on habit and practice. Besides, those oriental tribes 
appear to have a power, or rather a faculty, in regard to breathing 
which the occidentals know little abo t. They will spend days, 
weeks, and even months, in self-induced cataleptic conditions, ex- 
cluded from the air and light, and afterward recover. 

Persons f idling into the water in a state of syncope, or having re- 
oeiyed a concussion of the brain, have been revived after the immer- 
sion of half an hour. Newly-born animals will survive much longer 
than adults; and the lower the temperature, the less rapid is the 
asphyxia. 

In this condition the blood from the lungs reaches the heart un- 
changed, and in the venous form. It is transmitted thence through 
all the arteries and textures of the body. Its circulation through the 
brain paralyzes the sensorial function, and produces unconsciousness. 
The functions of the medulla oblongata arc also enfeebled. The 
blood now becomes still more venous and disorganized; and the 
capillaries of the lungs receive it with difficulty. It collects in the 
right ventricle of the heart, and flows less in the arteries. The ex- 
tremities become cold, the circulation is finally arrested, and death 
ensues. This is the mode of death not only by drowning, 
but by deleterious gases, and, generally, when a person is hanged. 
Despite the representations of its painlessness, we can with difficulty 
consider it as anything but torturous and cruel. 

The catastrophe of the Black Hole, in Calcutta, is familiar to every 
reader. A large number of men were immured there over night, 
most of whom perished of asphyxia. Similar disasters have resulted 
under analogous circumstances. In the earlier period of the African 
slave trad % multitudes of negroes perished in this way while on tl e 
VOy&ge across the Atlantic. 

The crowding of rooms and public halls, it will be seen, is a pro- 
lific source of mischief. Disorders have been contracted in this way 
which become permanent and incurable. The diseases popularly 
denominated zymotic, and by the Homoeopathies psoric, are often 
the sequence of exposure to bad air. It is notoriously prolific of 



DISEASES FROM IMPURE AIR. 51 

contagion. While pure air will neutralize and render innoxious the 
contagium of any known disease, impure air will disseminate it far 
and wide, if not generate it outright. The panics in regard to epi- 
demic would all be obviated by proper attention to drainage, cleanli- 
ness and ventilation. Gen. Butler once banished and excluded yellow 
fever from New Orleans; but the inhabitants and their government 
brought it back with all its deadly accompaniments. It is a form of 
malignant typhus or typhoid, to be resisted by pure air and cleanly 
habits ; but never kept away by quarantining. 

The Asiatic cholera is another pest, the outgrowth of similar causes. 
Small-pox, diphtheria, scarlatina, pneumonitis and a swarm of kin- 
dred ailments spring up from badly -ventilated places like mushrooms 
from a hot-bed. We know of no prophylactic except what we have 
indicated. 

The great scourge of our country and Europe, pulmonary consump- 
tion, must be included. It is charged to the account of cold weather, 
northern climates and hereditary \ predisposition, perhaps; but we 
are bold, audacious, to impute its existence to imperfect nutrition 
and bad air. It is impossible to have good digestion without the 
nervous system in proper tone and nourished with healthy blood. 
The venous circulation is always in quest of nutritive elements to 
supply those with which it has parted. Many of our feelings of 
restlessness, even our sharp pains, like neuralgia, are due to this 
cause. 

Imperfect digestion is necessarily the prelude to imperfect assim- 
ilation; and this is the starving of the tissues. Disease is then 
inevitable. The blood is fevered by privation of its necessary 
aliment and either fails to nourish the fibres or to supply a diseased 
material which results in a morbid growth. Scrofulous deposit, 
tubercle, cancer, all are a 1 ike, as the cacoplasm is of the cell, nu- 
cleus, or prior molecule. These disorders are not without a certain 
contagious character. Inoculation will transmit them ; and the pecu- 
liar sputa of phthisis will infect those who inhale it. The epithelial 
surfaces are easily impressed with deadly virus, from whatever source. 



53 PHYSIOLOGY. 

The air readily takes it up. If the oxygen is in volume sufficient it 
will neutralize and destroy the poison, but otherwise the air will be 
instrumental in its diffusion instead. 

It is the opprobrium of t e Eastern States that they are hot beds 
of consumption. Certainly they display an extraordinary mortality 
from that cause. We have not time to give all the reasons wh ch 
have been assigned. A few however are in point. One has been 
instanced by the la e Theodore Parker. His own family was robust 
and exceptionally long- ived. But one of the number erected his 
hous • on a side-hill above an expanse of marsh. His descendants 
w re tainted and die I prematurely of < onsumption. This cause exists 
extensively over Connecticut and Eastern Massachusetts, where the 
filment appears aim jst to be epidemic. The air of wet ground is 
laden with poisonous emanations, many of them undiscoverable by 
chemical tests. They not only poison the blood, but more or less 
paralyze the nervous system. 

The thousands immured in factories where labor is irregular and 
often unwholesome and the air seldom pure, are exposed from the 
inception. We have but to add that the eastern house, till a com- 
paratively recent period, was constructed as if to exclude the sun- 
light and atmosphere. Without these, healthy blood is impossible; 
yet they seem to have been run away from as if they were adver- 
saries. 

A healthy condition of the blood is necessary for a healthy forma- 
tion of texture. This implies that all the processes of nutrition 
should be properly performed. The disturbance of any of them, as 
has been shown, impairs the growth and structure of the body. The 
blood, being itself a living substance, with consciousness, instinct and 
other properties, has the power to separate a d get rid of deteriorated 
dements as well as to obtain needed aliments. The pus-cells of 
small-pox, the new epidemic of scarlatina and the peculiar emana- 
tions of various disorders are results of the effort of the blood to 
free itself from unwholesome substance. 

A proper quantity of blood in a part is necessary for its nourishment. 



BLOOD FLOWING TO A PART. 53 

If a principal vessel is' destroyed or injured the parts supplied by 
it also waste and perish. When parts of the body are growing they 
attract more blood to them than usual. We observe this in an infinite 
variety of instances. The arms of mechanics become large and dis- 
tended ; and any part subjected to friction speedily reddens with the 
suffused blood, the textures thickening and what is called callus also 
forming. Young persons entering upon the period known as puberty 
experience an increased flow of blood to the sexual regions which 
both causes the enlargement of the various parts and increases their 
sensibility. All this is normal. But great care should be taken, 
during these processes, to avoid any undue enhancement of such cir- 
culation and sensibility. This tends to various disturbances of the 
economy and even to permanent evil. An abnormal flow of blood 
is certain to take place in any part of the body on which the atten- 
tion is fixed. The sexual feeling intensified in this way is likely to 
become a passion difficult of control; while the premature develop- 
ment thus induced weakens that portion of the organism. The nerv- 
ous system is involved, the nutritive processes disturbed and the body 
weakened. Precocious manhood and womanhood are perhaps among 
the less of the evils. Some marry or do worse and so become prema- 
turely old ; others pine and suffer from a host of nervous, dyspeptic 
and other ailments; and very frequently masturbation is ad opted as the 
surest and most accessible relief. From being a vice, an infraction of 
sexual integrity and a corrupting of the moral sense, it often becomes 
an irresistible propensity, itself a disease as ineradicable as a cancer. 
It is impossible to nourish a part properly except it is in a healthy 
condition. Every texture, every cell has in itself the appetite, the 
elective affinity, the property of attracting and selecting materials 
from the blood for its own growth and repair. It is therefore certain 
that if the cell or tissue is itself injured, in an unhealthy condition, 
or destroyed, it cannot assimilate nourishment, or at least do it 
properly. Hence we encounter so many diseases of texture which 
seem to resist effectually all the interference of art. We may per- 
ceive why it is that blows and other injuries, by exciting or diminish- 



54 PHYSIOLOGY. 

ing the vital properties of the textures, give rise to inflammations, 
tumors and other morbid growths. 

In combination with all these operation?, the influence of the 
nervous system is imperative. If this is impaired, no healthy growth 
or assimilation is possible. There is not an organ of the body which 
is not likely to be deranged or modified in function by conditions of 
the mind. Hope and confidence aid in the resolution of numerous 
diseases; fear and foreboding of evil aggravate the most simple mal- 
adies and often render dangerous ones fatal. The destruction of a 
nerve will cause the wasting of a tissue, and often its ulceration and 
total destruction. The same thing occurs when disease attacks the 
spinal cord or one of the ganglia of the sympathetic nervous system. 

The operations of life are therefore comprised in nutrition and ex- 
penditure of substance. On the one hand, material is always passing 
from the blood to build up the tissues; on the other, matters are pass- 
ing into the blood from those tissues which have fulfilled their pecu- 
liar functions. The new takes the place of the old, preserving the 
general configurat : on of the body, during the constant imperceptible 
changing. We cannot see the tissues forming in the adult, but may 
in the embryo. We are obliged to infer or guess at the process. But 
we cannot, even then, perceive the disintegration and absorbing. 
We are obliged to learn what Ave know of it from morbid processes. 
We perceive, for example, that pus-cells and caneer-cells break down 
and become fluid in the very inverse order to that in which they were 
developed. A fluid exudation issues from the blood-vessels, and 
coagulates in the form of molecules and granules. These unite to 
form nuclei, around which cell-walls are produced. In case this is 
their final poinl of development, they are again dissolved into fluid. 
The cell-wall melts first, and then the nucleus. The molecules and ' 
granules appear again. The fluid portions pass through the walls of 
the blood-vessels from without inward, and so enter the circulation. 
So all which was solid has become liquid, to pass again into the 
blood. This process is denominated absorption. 

We do not witness it in health, but infer that it is analogous. We 



ELEMENTS OF THE BLOOD. 55 

suppose that particle after part icle of solid matter is reduced to fluid 
and disappears to give place 10 new particles ; and that these also 
become solid for a time, assume form, fulfill their functions and 
allotted period of life, are again dissolved, absorbed and excreted, as 
their predecessors were before them. 

So we have two digestions. The blood receives matter from the 
primary digestion to build up the tissues and form the secretions; 
and likewise from this secondary digestion, to produce the excretions. 

Chemists have not been very successful in their manipulations of 
the vital fluid. It is different in the two sexes, as well as from cir- 
cumstances of diet, assimilation, respiration, personal habits, etc. 
The medium quantity is 34£ pounds in a man and 26 in a woman. 
It is supposed to comprise one-fifth of the entire weight. 

The constituents of the blood are the plasma, or liquor sanguinis, 
the red corpuscles, the leucocytes, or white corpuscles, and the granules. 
The plasma is a yellow fluid, slightly viscous, in which the corpuscles 
float, and the albumen, fibrin, fat and earthy salts are dissolved. It 
thus contains every substance necessary for the formation of the 
tissues and for the secretions. It is the essential material, the nour- 
ishing fluid, which is attracted through the walls of the capillary 
vessels by the tissues, to be employed, as elsewhere shown, in all the 
formative purposes of the economy. 

The blood-corpuscles, though denominated red, are really of a 
saffron or amber color. Under the microscope they are transparent. 
It is only when they are grouped thickly together that they take 
their red hue. They give the blood its peculiar color and opacity. 
They are truly organized structures, containing nitrogenized and 
mineral elements, as well as a little fatty matter. They are constantly 
undergoing decay and are capable of generating themselvfs. They 
constitute about half the mas* of the blood, and are but little denser 
than the plasma. It was supposed that they were actual cells having 
nuclei, a distinct organic substance; but this is not the case. The 
corpuscles have a tendency to range themselves in rows, like rouleaux 
of coin. This is because there exudes from each of them an adhesive 



5G PHYSIOLOGY. 

substance which glues them together. It is, however, not a phenome- 
non of the living blood, but takes place speedily after death. Their 
structure is very simple. They have no nuclei, nor granules, nor 
investing cell-wall, but are perfectly homogeneous. They are char- 
acterized by great elasticity, the power of osmosis, and the possession 
of a glutinous substance. They constitute the plastic material of the 
blood, and fit it for the purpose of nutrition of the tissues. In the 
circulation, they keep the capillaries open, so as to permit the passage 
of the arterial contents; they absorb oxygen in the lungs, and after- 
ward give it off in the different parts of the body, and so maintain 
the animal heat Their removal by hemorrhage, or bleeding, occa- 
sions asphyxia, such as slaughtered animals experience. 

Thus the blood is a highly elaborated, viscous and complex organic 
liquid It is the blastema from which the living molecules, nuclei, 
cells, and other elements of the tissues are attracting, by a kind of 
hunger, as has been shown, new matter to supply the place of what 
is lost; meanwhile, it is also all the time absorbing old matter which 
has already served its uses. "We do not know how it brings all this 
material into use, which it derives from the primary and the second- 
ary digestions. AYe comprehend that it is in constant motion, rush- 
ing rapidly out from the heart through the arteries; that it is divided 
into minute streams by the capillary vessels which permeate the 
parenchyma of the tissues: that it returns more slowly by the veins, 
completing this whole circuit in half a minute; that it is subjected to 
the constant collision of about two billions of semi solid blood-cor- 
that it is incessantly undergoing alterations when exposed to 
the peculiar action of every organ of the body— and nil the while that 
it is imparting one or more of its constituent principles to the 
various tissues as it passes through them, it is at the same time 
absorbing those which have been worn out in the service of the 
economy. 

In the circulation, therefore, the tissue-building and the tissue- 
dissolving principles are mingled. We must look there, accord- 
ingly, for an explanation of numerous morbid conditions which 



EFFECTS OF LOSS OF BLOOD. 57 

derangements in so nicely-balanced an organic fluid is liable to pro- 
duce. 

Hemorrhage is perhaps the most mischievous agency for deranging 
the blood. Its effect is to greatly diminish the number of the red 
corpuscles, on which every function and organ so intimately depends. 
For many years it was the leading step in medical practice. Patients 
were bled on every occasion, in every condition, and for pretty 
much every disorder. The spare as well as the plethoric, the con- 
sumptive as well as the apopletic, and especially pregnant women, 
were alike made to shed their blood to the medical Moloch. An old 
man like General Washington, an exhausted patient like Lord Byron, 
an overtaxed statesman like Count Cavour of Italy, in like manner 
lost their lives by this unwise practice. Blindness seemed to possess 
the entire profession. Never, perhaps, was the art of healing more 
destructive. 

When all the constituents of the blood are abundant the condition 
is denominated plethora. When they are deficient the state is •termed 
anemia. In inflammation the fibrine is largely increased, the choles- 
trin doubled in quantity and the albumen diminished. In fevers, 
exanthematous disorders, intoxication, starvation and purpura hem- 
orrhagica, the albumen is diminished. Upon the checking of any secre- 
tion, its essential principles accumulate in the blood. In the follow- 
ing diseases the albumen is abnormally diminished in the blood, 
namely: Bright's disease, cardiac dropsy, and puerperal fever. 

The blood sometimes clots in the vessels during life. This is liable 
when the circulation has become retarded, as on the slow approach of 
death. When a ligature is applied to an artery the blood will coagu- 
late in its neighborhood, filling up the entire vessel. Sometimes 
these clots have formed in the cavities of the heart and extended into 
the large vessels. Whenever the blood is effused into the areolar 
tissue or any cavity of the body it generally coagulates, and is after- 
ward softened and removed by absorption. 

The chief office of coagulation is the arrest of hemorrhage. It 
never takes place in the organism except the blood is in an abnormal 
3* 



58 PHYSIOLOGY. 

condition in respect to circulation. There is serious danger of injury 
in such cases. The impaction of portions after being broken up is 
likely to occur in distant vessels, producing embolism. When this 
occurs in the brain we have cerebral apoplexy; and the formation of 
clots in the heart is liable to prove fatal at once. 

Concerning toxihcomia, or blood-poisoning, pathologists have been 
somewhat neglectful. Many diseases, some of which are the oppro- 
brium of the medical profession, are due to this cause, more or less 
directly. Thus we have hospital poisoning, from putrid pus, com- 
monly known as pyhamia, or more properly septicaemia,, nowadajs 
accounted for by the " germ- theory," but still a moot question. 
Syphilis is perhaps more general, not only tainting the blood, per- 
haps ineradicably, of the individual, but inducing a permanent caco- 
plastic tendency in his remoter progeny. Scrofuli, in its myriad 
forms and ramifications, is now prevalent over Europe and North 
America; and there i-> little doubt that it is the sequence of the prev- 
alent syphilis which from 1495 till 1550 and later scourged the vari- 
ous countries, from X; pics to Spain and France, then Saxon Ger- 
many, Poland and England, following into Hungary, Russia, 
Sweden, and finally into Swabian Germany. Erysipelas is perhaps 
more universal. Its virus comes fiom decomposing flesh; its viru- 
lency is hardly surpassed; and if it is not itself the one blood-poison 
from which the others take form, as we more than suspect, it ( er- 
tainly appears de novo when any of them are developed. Its types 
arc myriad; and we find it not only with scrofula, but small-pox, 
phthisis, diphtheria, scarlatina, measles, rhus poison, etc. When it 
has once appeared, it betrays a strong tendency to manifest itself 
again at the recurrence of the season. 

Venomous insects and animals also diffuse a virus or poison more 
or test deadly, which is capable of disorganizing the blood, and often 
of producing death. Chemists have declared that the poison of ser- 
pents and venomous insects was acid, and of similar properties. 
Analogy, however, indicates to us that it is in each instance, like the 
blood, peculiar to the animal from which it is secreted. How far the 



BLOOD POISONS. 59 

deadly effects are due to quantity, or to the intensity of the poison- 
ous principle in each instance, is the theme of important enquiry. 
The bite of the hooded snake, the cobra, is almost certain death. 
The Urseus, or Sacred Asp of Egypt is little less deadly. The Ameri- 
can rattlesnake is pretty certain to inflict death when his fangs wound 
a vein or artery. Fortunately the majority of the serpent tribes are 
not poisonous. If the venomous principle is acid, it is easy to per- 
ceive that a pungent alkali like ammonia would speedily neutralize it 
and arrest its ravages. But when the blood itself is tainted to any 
considerable extent, the disorganization cannot be overcome. The 
brain and nervous system are more or less paralyzed, and the shock 
on the ganglionic nerves is irremediable. 

It is worthy of notice that the intensity of the poison is more or 
less affected by various conditions. Thus, snakes hibernate and are 
dormant or unconscious for long periods. They seem to be little 
venomous during and immediately after these* intervals of torpidity. 
When, however, they have lain in the sun and acquired new force, 
they become dangerous. The excitement of anger in them also 
increases the deadly character of their poison. 

Indeed the passions generally have a malignant influence in most 
animals. Anger is a potent blood-poison. Women nursing their 
children during a period of rage have thus put an end to their life. 
Fear disorganizes the blood. Much of the mortality prevailing dur- 
ing epidemics is due to this caus3 alone. Disappointed love will 
derange the nervous system, pervert the sensibilities, and disorder the 
digestive and respiratory systems. It is a frequent cause of pulmonary 
Consumption. The bite of enraged animals not unfrequently pro- 
duces convulsions and blood-poisoning. Even men and women, in 
moments of passion, have inflicted similar injury by biting. Hydro- 
phobia, the puzzle of pathologists, is a disease created by intense 
nervous excitement. It has been attributed with much reason to 
erosis; dogs being exposed to the presence of the females and at the 
same time kept forcibly apart. The bite of the oestruating female is 
said to have occasioned hydrophobia in several known instances. The 



60 PHYSIOLOGY. 

bite of other animals, however, has been observed in numerous cases 
to occasion disorders of an analogous character. But if we should en- 
deavor to trace the relation of cause and effect between disease and 
the imagination and passions, it would be an interminable labor. It 
is plain to the most unobservant that ill habits of mind, neglect of 
self-control, yielding to anger or any lawless impulse, enfeebles the 
vital force and predisposes to disorder. Insanity is only such disor- 
der in some aggravated form. 

Vegetable poisons are as potent in their way. We tread upon 
the province of the prescriber and apothecary when we instance 
opium, belladonna, aconite, hyoscyamus, strychnia, calabar bean, 
veratrum, gelseminum and the major part of the materia medica, per- 
haps. But it is certain that in quantities of any considerable amount 
they disorganize the blood and produce death. All that the physi- 
cian endeavors to do with them is to employ doses so minute as to 
modify what he considers a morbid action, avoiding the toxic or 
poisonous effect of any considerable quantity. He can hardly be too 
careful or discreet. It is a remarkable and most forcible illustration 
of the potency of vital over what we denominate chemical properties 
that a drug like opium or strychnia, not materially differing in con 
stituents from gluten or albumen, should be endowed with the power 
to arrest the action of the physical economy. What is not under- 
stood infinitely transcends all that we know. 

Mineral poisons in their various forms are also destructive to the 
blood and tissues. The vapors of chlorine, carbonic oxide, sulphur, 
mercury, arsenic are familiar to all. Many of the minerals themselves 
are known poisons. Mercury, arsenic, antimony, lead, cobalt are 
noted C6r their potency and deadly character. A better knowledge of 
human BCience, of physiology and hygiene, and we trust better sense 
among physicians, is steadily impelling the more intelligent and con- 
scientious to the rejection of these substances in medical practice. 
It would he a golden age made celestial to have a treatment of the 
sick in which poisoning by medicines was not a feature. 

Attention has already been directed to the fact that the textures of 



EXCRETION. 61 

the body while assimilating and appropriating new material from the 
blood also give up to that fluid the particles which are effete and 
worn out. These are in a fluid form; but being more or less changed 
constitute the fibrine and a portion of the fat extractive matters and 
salts which appear in the liquor sanguinis. They are the result of 
the secondary digestion — the disintegration of the tissues; and being 
useless for the economy are separted and excreted. 

A large part of this, as has been shown, is performed by the lungs. 
They exhale daily from six to twenty-seven ounces of water and 
from four to twelve ounces of carbon. Their importance as 
depurators cannot be exaggerated. The necessity of abundance of 
pure air, of thorough ventilation and cleanliness, should be insisted 
upon everywhere. 

The liver stands sponsor for a large proportion of the disorders 
of which people complain. We will here remark that in many cases 
it is an unjust imputation. Most of them are not hepatic or bilious. 
It is a designation which has been adopted to answer the enquiries 
of ignorant people, if not also to disguise the ignorance of the physi- 
cian. The office of the liver is to free the blood from the grosser 
elements which contaminate it. The portal vein which supplies it 
originates principally from the capillary vessels of the intestines; 
hence the blood contained in it abounds with fat, dextrine and sugar 
but is deficient in fibrine, which is a product of the secondary diges- 
tion. It accordingly will not clot firm'y like blood in other parts 
of the body. The food which has parted with its better elements in 
the formation of chyle also gives off others for the production of the 
bile. The liver is the purifying organ for the chyle, the blood and 
espe ially of the liquor sanguinis. Its vessels, the biliary passages 
and ducts are as so many sieves for separating the various substances. 
It perfects the work of the spleen and pancreas in the preparing of 
the chyle; each of these organs transmitting to it the impure blood 
which they have encountered. So spontaneous is every operation in 
the liver that motion is almost imperceptible. The blood which 
is impure, unwholesome, effete and useless, is removed and trans- 



62 PHYSIOLOGY. 

mitted to the gall-bladder. This fluid has been curiously and not 
improperly associated with moral qualities. Ill-affected persons are 
denominated bilious; and the term melancholy in its etymological 
sense signifies black bile. As much of the bile is taken up anew into 
the bloo I, is it unrensonable that a peculiar depression of spirits 
should attend the infusion of a darker-colored flui I into the cir- 
culation ? In morbid conditions such as are frequently accompanied 
by this state of mind the blood is sluggish, viscid, dusky and lifeless 
in its aspect. 

The secretion of bile is affected by a great variety of influences. 
All causes that affect the blood are of this character. Indigestion, 
disease of the stomach, the obstruction of perspiration, fevers, poor 
food, etc., all are in this category. So too are mental disturbances, 
like anger, envy, anxiety, grief. Too intense application to study, 
indolence, the habit of brooding over misfortune or dark prospects, 
the regarding of evil rather than good in whatever is done or hap- 
pens, sudden disappointment, all affect the blood unwholesomely 
and adulterate the bile. 

The average product of bile is about 3 1-2 pounds daily. It con- 
sists chemically of water holding in solution various alkaline salts, 
and it is said copper, iron, coloring matter, mucus and fat. The 
coloring matter is five-fold; the salts consist of soda, potassa and 
ammonia united with the taurocholic and glycocholic acids. The fatty 
matter is cholestrin, which is essentially the fecal constituent. The 
orifice of the common bile duct into the duodenum is smaller than 
the duct itself and is closed by the contraction of that intestine. 
W ben, however, chyme and fluids distend it, the orifi e is thereby 
opened and the flow of bile facilitated. The major part of this fluid 
is absorbed into the blood and excreted from the lungs in the form 
of carbonic acid. The residue is converted into stereoraceous sub- 
stance and excreted as such from the large intestine. Hence it is that 
the bowels after having been thoroughly emptied of their contents 
are presently found again to contain fecal matter; and in those 
diarrhoeas designated feculent the quantity of matter voided is 



THE BILE. - 6a 

noticed to be in excess of the food taken. The quantity of bile 
excreted from the intestines as fecal is more or less in proportion to 
the amount eliminated by the lungs. In warm weather, therefore, 
when the rarefaction of the atmosphere limits this amount, the intes- 
tines are taxed for its excretion ; and hence originate the variety of 
complaints denominated bilious, choleraic, etc. The fatty matter 
not being properly removed often accumulates in the cells of the liver, 
creating what we know &s fatty liver. The organ enlarges sometimes*' 
to a prodigious size. Lack of exercise and a heated atmosphere pro- 
duce this condition. They diminish the respiration and thereby force 
upon the liver the function of disposing of the excess of carbon and 
hydrogen. This it is unable to do and so stores it up in the form of fat. 
The enormous livers, for which the fatted geese of Strasburg have 
long been famous, are thus produced. The disease also prevails in 
hot climates especially among Europeans. The lungs doing their duty 
imperfectly throw their burden on the liver, which accordingly pours 
an increased supply of bile into the duodenum, causing the symptoms 
commonly known as bilious. All persons spending a season in hot 
climates, and especially during the summer should be careful to adapt 
their diet to the amount of exercise they take and the vigor of the 
respiration. Carbonaceous, and especially oily food, should be 
avoided as well as alcoholic drinks. 

The employment of medicine to promote the secretion of bile has 
long been a hobby among medical practitioners. Experiment has 
shown conclusively that it is a delusion. The fact that a cathartic 
causes bile to appear in the fceces is not conclusive in regard to the 
secretion. It is known that a large part is usually transformed in the 
smaller intestine ; and the purgative only forces it out before this 
takes place. It has done hurt in this rather than good. "Whatever 
may be the utility of cathartic medicines the intelligent practitioner 
will never resort to them to enhance the supply of tile. 

Mercury, accordingly, never increases it, nor exercises a beneficial 
effect on the hepatic function. The idea that it does, is one of the 
hallucinations of the practitioners, without basis in philosophy or 



64 PHYSIOLOGY. 

confirmation by experience. A committee appointed by the British 
Medical Association in 1866 to investigate the subject, employed 
two years for the purpose. The result showed that on no occasion 
whatever did mercury increase the serretion of bile. Whenever it 
impaired the health or produced purgation, it diminished the flow, 
but otherwise it had no perceptible effect. The same thing was true 
of podophyllin. As for taraxacum or dandelion, it was inert. 
All purgation drained the walls of the intestines and so diminished 
the secretion. Abstinence from food also lessened it ; but there was 
no relation perceptible between the quantity of food eaten and the 
bile, which indicated the amount to be excreted at any given time. 
Sometimes it was more and sometimes far less, with the same quan- 
tity, in apparently the same condition of health. Exercise always 
increased the flow for a time, because it created a pressure upon the 
muscle's of the abdomen, expelling the contents of the gall-bladder. 
A strong contraction of the diaphragm and muscular parts surround- 
ing the bladder compresses it and immediately causes a flow of bile. 
Deep breathing continued for some moments will do the same thing. 
But the gall-bladder h;is no muscular coat and therefore will not 
contract on the application of a stimulus. It would seem that this 
determination of the question by men eminent for scientific and pro- 
fessional learning ought to be sufficient. There is, however, no 
ground for hope of any speedy benefit. Medical practitioners are 
reluctant to learn and more so to change. The issue now in con- 
troversy will eventually be decided in favor of the people. Till that 
time these drugs must be permitted to ravage, except where there is 
purpose and intelligence sufficient to resist the authority of phy- 
sicians. 

The function of the kidneys and their appendages are next in the 
order of examination. They are glands constituted of cortical and 
medullary substance, having for their office the depuration of the 
blood from earthy matter, water and waste nitrogenous substances. 
They also, to a degree, act upon fatty or saccharine matters. The 
failure of the lungs to cleanse the blood of hydro-carbonaceous ma- 



FUNCTIONS OF THE KIDNEYS. 65 

terial, imposes the task vicariously upon the liver ; and in like man- 
ner the delinquency of the liver transfers its burdens to the kidneys. 
It is not surprising that they are often diseased ; and, perhaps not, 
that such forms of disease have become more common of later 
years. 

The medullary portion of the kidneys is constituted of tubes di- 
verging outward from the lower region of those organs, dividing and 
becoming smaller. They are lined like other vessels with epithe- 
lium. The cortical substance consists of the Malpighian bodies, 
so called from having been described by Malpighi, and the tubuli 
uriniferi, which proceed from them. These bodies appear to be 
formed by an assemblage of capillary vessels coming from off the 
renal artery, and are not unlike bunches of currants in appearance. 
They are surrounded each by a capsule formed from the expansion of 
the end of the urinif erous tubule. We may perceive from this that the 
Malpighian bodies receive the water from the blood and pass it into 
the tubules which are lined by glands and epithelium. The ureters 
convey it to the bladder in the form of urine. This fluid consists of 
a large part of the water entering the body as drink; also of refuse 
elements from the primary digestion and material produced by the 
secondary digestion, or disintegration of the tissues. Under a chem- 
ical examination it is found to contain about 97 per cent, of water, 
1 1-4 of urea, 2-5 of uric acid, 1 of mucus, coloring and extractive 
matter and the residue of sulphates, phosphates, chlorides, hip- 
purates and fluates of soda, potassium, lime, magnesia and ammonia. 
Its specific gravity varies from 1012 to 1030. It is very liable to be- 
come loaded with foreign substances, as blood, albumen, pus and sugar. 
Hence a careful examination of this fluid is important, and should 
not be neglected tiy the careful and intelligent practitioner. 

The quality of the urine is intimately related to every mental, 
physiological and pathological condition. Its color is pale when 
very dilute, and high-colored when comparatively scanty. The dis- 
ordered and excited condition of the nervous system produces a 
peculiar cast or complexion, which a skilful observer may easily 



66 PHYSIOLOGY. 

detect. The imperfect preparation of urea from the second digestion 
tends to create instead an undue quantity of uric acid, which not 
only produces rheumatic, gouty and neuralgic affections, but gives a 
high color to the excreted fluid. Studious persons are characterized 
by an increase of phosphatic and other salts, which are evidently the 
product of disintegrated tissue of the brain. Anj r urinary disturb- 
ance, even the neglect to void the secretion, will create more or less 
disorder in the head and particularly at the medulla oblongata. The 
food eaten also manifests itself by the urine. Articles of peculiar 
pungency are easily noted, like asparagus, terebinthinc substances. 
Vegetable diet increases, and animal food diminishes the volume of 
the excretion. It varies with every genus of animals, every age of 
life, with each sex, with temperament, habit of body, change of 
employment or weather, with diet or exercise, as well as with each 
specific ailment or disease. It is more or less suppressed in dropsy, 
fevers, malarial poisons, and is abundant as well as more or less 
crude, in indigestion and aualogous conditions. In pregnant women 
a caseous and oily substance is eliminated; and in other instances 
more or less oleaginous matter may be found in this secretion. 

Mental disturbances play their full part in the matter. A gloomy 
condition of mind increases the watery accumulation. Studious per- 
sons have more occasion to void the bladder than others. In hysteria 
there is often an apparent suppression, at least a suspension or over- 
looking of the requirement to discharge the burden ; this may be 
corrected by plunging the hands of the patient into cold water. A 
shock upon the surface speedily reacts upon the kidneys; as indeed 
do most impressions on the sympathetic nervous system. Every 
cause Imaginable, it will thus be perceived, will create changes in the 
elements, quantity and appearance of this fluid. 

The principal office of the kidney is to separate urea and uric acid. 
two Bubtancee rich in nitrogen, from the blood. About an ounce of 
the former and 8 grains of the latter are excreted daily by a healthy 
man. Children excrete double the quantity. If oxygen and water 
enter abundantly into the arterial blood there is a greater proportion 



ABNORMAL URINE. 67 

of urea and carbonic acid formed from the albuminous elements; but 
in case a less supply of oxygen is had, the uric acid is more abundant, 
which is insoluble, hard to eliminate and therefore liable to create 
disorders in the body. In acute diseases this fact is specially mani- 
fest. The urine is loaded with urates. In pneumonia, pleurisy and 
large abscesses it constitutes an important element of the crisis. It 
is also a distinctive feature in fever, phthisis, active dyspepsia, sup- 
pressed perspiration, blows and strains in the loins and disorders of 
the sexual system. All disorders which produce rapid emaciation 
are so characterized. In gout the uric acid is formed in derange- 
ments of the primary digestion; in rheumatism from disturbances in 
the disintegration of the tissues. Hence in the latter disorder the 
appication of heat is beneficial, as hastening the process and en- 
abling the kidneys to remove the acid. Occasionally uric acid is 
deposited in insoluble form in the kidneys or bladder and gives rise to 
calculi. Whatever the various ingredients of these formations, the 
nuclei are generally of this character. When the excretory functions 
of the kidneys are disturbed, dropsy and ursemic poisoning are the 
phenomena most likely to occur. In the former case the water, not 
able to escape by the natural outlet, travels through the walls of the 
blood-vess; Is, producing anasarca or general dropsy. In uraemia, 
the symptoms are of a nervous character, as are incident in blood- 
poisoning. Convulsions and coma are most common. 

The bladder receives the secretions from the kidneys and expels 
them from time to time. This is normally a voluntary action, a 
peculiar sensation dictating the proper period for the act. In inflam- 
mations of the neck, occcasion^d by quinia, gonorrhoea or inflamma- 
tion, the call is made more often than in health. It is unsafe to 
neglect the matter. The omission eventually produces a suppression 
of the usual call ; and the coats of the viscus are liable to reabsorb 
the contents. This would leave the salts and earthy matters more 
condensed and ready to crystallize. In this way calculous dis- 
order may be rendered imminent; and the blood will at the 
same time be vitiated by the effete material again thrown 



68 PHYSIOLOGY. 

upon it. The skin attempts to relieve the body, and hence 
the peculiar urinous odor from persons in the habit of this peculiar 
neglect. Kidney disease of various kinds is also thus made liable; 
and dropsy with its pernicious accompaniments. The sexual appar- 
atus is naturally and even necessarily involved in the general dis- 
turbance; and the disorders incident to aberration or suppression 
of the instinct, are sequences. The physician learns less about 
them; the patients are generally particular to direct his attention to 
other phenomena and symptoms. The disorders out of which cer- 
tain practitioners make their harvest, female diseases, often originate 
in this manner. A glance at the structure and arrangement of the 
pelvic viscera will show this. The rectal extremity of the colon 
passes down next the spine. Immediately before it is the womb, 
which in a healthy, well-disposed woman, keeps its position and in- 
tegrity of character, as though it was itself a sentient living being. 
The bladder occupies the foreground. While it leceives the proper 
attention which it demands, it keeps its place, performs its office 
normally, and produces no disorder or disturbance in the neighbor- 
hood. But women are proverbially careless in matters of health, as 
well as often factitiously and fictitiously modest. When in mixed 
society, or engaged in some employment or fixed attention, they neg- 
lect for hours this imperative requirement. The viscus distends and 
finally enlarges itself permanently to accommodate itself to the state 
of affairs. The watery parts of the urine are more or less returned 
to the circulation, to be excreted by the skin, taken into the tissues, 
or placed elsewhere as it ought not to be. The kidneys succumb, 
and so a variety of complaints from this cause become an incident 
of womanhood. The enlarged bladder must have space. It cannot 
ascend into the abdomen; indeed, the peculiar fashions of female 
clothing would prevent that. It finds its way backward, lying upon 
the womb, and displacing as well as enfeebling that organ. We do 
not see how it can well be otherwise. It is not necessary now to go 
Into detail in regard to the mischiefs which are thus occasioned. 
Such disorders are so common, so many practitioners make a busi- 



FUNCTIONS OF THE SKIN. 69 

ness of treating them and the prevalence of them is so genteel and 
fashionable, that we have a literature on the subject as copious as 
on any department of real science. Gynaecology has taken dimen- 
sions, and has its books, periodicals, schools of practitioners, almost 
excluding from its domain all other medical, physical and path- 
ological science. 

The supra-renal capsules appear to pertain rather to pre-natal exis- 
tence. They abound in lymphatic vessels, showing a close relation 
to the function of assimilation. After birth they change and finally 
become of little account. 

The skin and its functions are too important to be passed over 
lightly. In its constitution it somewhat resembles the mucous mem- 
brane ; consisting of a membrane of areolar and elastic fibrous tissue, 
lying like a close mesh- work over all parts of the surface. Beneath it 
is a layer of fat which protects it from injury and sheaths the internal 
organs. It is abundantly supplied with blood and nervous power; 
indeed it seems to be almost a network of nerves and blood-vessels 
alone. The ramifications of the nerves, with which it is furnished, 
constitute in fact a larger mass of nervous matter than is contained 
in the nerve-trunks from which they arise. So numerous, at the same 
time, are the blood-vessels that the finest needle cannot pierce any- 
where without wounding some of them and drawing blood. The 
peculiar redness in bleeding also indicates the great vascularity of the 
organ. In surgical operations, the chief pain is inflicted at the skin, 
showing its extreme sensitiveness. 

The epidermis, cuticle or scarf-skin, is a membraneous layer every- 
where laid upon the true skin. It is of a homogeneous structure and 
has l. either nerves nor blood-vessels. It is composed of epidermic cells 
piled up all over the surface in layers of different thickness; being 
thin on the lips and flexures of the joints and thick where the parts 
are subjected to pressure. They issue from between the papillae or 
follicles of the true skin, where they may be seen under the micro- 
scope in all stages of formation, as molecules, nuclei, cells. They 
are pushed out and so spread over the entire surface. Those nearest 



70 PHYSIOLOGY. 

the skin are fusiform, moist and have their walls soluble. But they 
undergo a change. Matter of a horny or cartilaginous nature is 
deposited in them and they dry away, becoming layers of scales over 
the entire body. Physiologists used formerly to regard the moist 
cells as pertaining to a distinct tissue, the rete mucosum, or mucous 
network. It was regarded as the seat of the coloring matter, pro- 
tecting the true skin from contact with the rougher epidermis. But 
this opinion is not now generally entertained. The net-work of cells 
of which this coat was supposed to be constituted was found to be 
inseparable from the exterior scarf-skin, showing that it was no less 
than its inner surface. The cells of which it is constituted become 
in time the horny scales which compose the epidermis. 

The skin is essentially an exhaling body. It is constantly excreting 
watery and fatty matters. Indeed the epidermis itself, the hair and 
nails which are modifications of the epidermis, are also in a certain 
sense, excretions. When they have grown to a certain extent, they 
become effete and fall away. 

The sweat-glands are at irregular points under the skin. They 
separate various substances from the blood and excrete them through 
a tube upon the surface of the body. This tube consists of a firm 
membrane lined by epithelium and runs in a straight course till it 
reaches the epidermis, when it becomes spiral or twisted. These glands 
are most numerous in the palms of the hands and soles of the feet, 
suggesting care and punctuality in the ablution of those parts. 
Krausc estimates the number at these points at 2736 per square inch; 
Wilson, at 3590. They are less numerous on the back of the hand, 
tli< face and neck; still less on the body and arms; and least of all 
on the back, where the number is set down at 400. They secrete the 
sweat, which i- for the most part exhaled from the body in the form 
of vapor. But when from exertion or other cause it is increased in 
quantity, it is not readily evaporated and appears in the form of 
minute drops on the surface. 

In i ealth the sweat consists principally of water holding fatty par- 
ticles in BOjpensi n and a small quantity of salts of soda, potassa 



CUTANEOUS EXHALATION. 71 

and lime. Its reaction" is acid to test paper, but it becomes alkaline 
after exposure. During copious sw eatings there is also a considera- 
ble quantity of urea and other nitrogenous matter, the elimination of 
which is the province of the kidneys. In disease there are also 
uric acid, gluco-e, albumen and biliary coloring matters found; and 
occasionally such medicines as iodine, potassium iodide, benzoic, 
succinic and tartaric acids are exhaled in this manner. The amount 
of sweat given off daily varies greatly; as much as five and less than 
two pounds having been observed. The cutaneous exhalation is thus 
more abundant than the united excretions of the bowels and kidneys. 
As the weather becomes warmer or colder the kidneys and skin alter- 
nate in the proportions of the work which they severally perform ; most 
being excreted by the skin in warm and by the kidneys in cold 
weather. The quantity of perspiration increases after meals, during 
sleep, in dry warm weather and when the skin is stimulated. It is 
diminished when the atmosphere is moist or the digestion impaired. 

There is an analogous relation also between the functions of the 
skin and those of the lungs. Animals covered with a thick varnish 
die from asphyxia. The lungs and right side of the heart are con- 
gested, and the temperature of the body sinks 36° F. It is probable 
that the composition of the sweat varies at different ages, and also 
on different parts of the body. The peculiarities of odor indicates* 
as much. The arm-pits, groin, forehead, hands and feet perspire 
most readily, and receive for the purpose a proportionately largt* 
supply of blood. Checking of the perspiration is most detrimental 
to health. A bowel complaint, pneumonic fever, or inflammation 
of some internal organ, is very apt to ensue from cold applied to the 
skin, or continued exposure on a cold day. This is largely the re- 
sult of retaining effete matter which ought to have been carried off 
by that organ. If the internal structure is entirely healthy, the 
additional labor is performed, and equilibrium presently restored; 
but in case of weakness of any, as of the lungs and kidneys, disorder 
is likely to ensue. 

Burns and scalds, often of no great extent, prove fatal because of 



72 PHYSIOLOGY. 

the internal, generally intestinal inflammation which they create. 
The disorganizing of a large nervous and exhaling surface, occasions 
a great nervous commotion and the suspension of an important 
excretion. Baron Dujiuytren expressed the belief that death would 
ensue when more than one-eighth of the surface of the body had 
been severely burned. 

Others discover a peculiar sensitiveness when vinegar, or any 
diluted acid is applied to the body. It will even occasion convul- 
sions and severe griping pains. Analogous results have ensued from 
substances taken into the stomach. Nettle-rash and other eruptions 
of the skin are produced by eating of shell-fish and other substances. 
Eczema, or vesicular eruptions, occur when Europeans first en- 
counter a hot climate. 

We perceive why eastern moist climates are unhealthy. There is 
a diminished evaporation from the skin, so that the outlet of the 
superfluous heat is partially shut up. The waste matter is as in- 
jurious as an active poison, and the fevers, colds, and dysenteries 
thus occasioned, are very well accounted for. 

The sebaceous glands are also found in most parts of the skin. 
They secrete an oily fluid which is sometimes half solid, and of the 
character of wax. It seems to lubricate the skin and prevent it 
from chapping and scalding. It is removed by bathing, but the loss 
is speedily supplied. Dark-complexioned persons and the races in- 
habit ing warm climates, appear to be most abundantly furnished in 
this respect. The ceruminous glands of the ears, and those peculiar 
to other parts of the body, which emit a distinct odor, are varieties 
of the sebaceous glands. It is probable that the scent of the secre- 
tion from these glands enables dog^s to detect and trace the person 
emitting it. 

It has been a debated question whether the skin possessed absorb- 
ent powers. The scaly epidermis, it is known, repels penetration in 
this manner. Deadly poisons applied to the surface rarely do much 
injury. Vet in many diseases, like diabetes, in spite of the great 
removal of moisture, the weight of the body is seldom proportionably 



ABSORBENT VESSELS. 73 

affected. Persons applying water to the surface have relieved thirst. 
The miasms of marshes are evidently absorbed in this way ; so too 
are the effluvias of the dissecting room. The poison of the plague 
appears to be contracted in this manner. Putrid matters influence 
the body in this way rather than by the lungs. The application of 
oil to the skin appears to protect, so also does flannel. Even in the 
malarial district about Rome, those who wear woolen clothing enjoy 
great immunity from intermittent fevers. In moist c limates we also 
notice a fulness of habit indicative of a predominant lymphatic 
system. All these considerations lead to the conclu^-ion that in dry 
Climates exhalation from the body is most active; while in moist 
climates the same thing is true of absorption. H( nee the more 
dry and spare bodies of those living in a dry atmosphere ; and the 
fall habits of those who inhabit moist climates. Dampness facili- 
tates the action of the absorbent vessels; so also does friction. Many 
substances which would be incapable of entering the pore*, are ab- 
sorbed by mixing them with some oily substance, and employing 
active friction. This causes them to enter the s< baceous and sudo- 
riferous ducts, from which they can be absorbed more rapidly than 
through the epidermis. But as a rule, inoculation of poisons can 
only be effected by first penetrating this membrane and bringing the 
substance into communication with the capillaries. 

The excretion by the large intestine is normally about 1-6 of the 
weight of the food eaten. It consists of the undigested aliment, 
mucus from epithelial disintegration, and various secretions which 
have come from the liver and other glands. Phosphates and other 
earthy matters are found. It is supposed that after the small intes- 
tine has finished its action and discharged its contents by the ileo- 
cecal valve into the large intestine, a further " chemical" change is 
effected. There is an acid liquid secreted there, and the substances, 
before of a fluid consistency, assume solidity. 4Jnder the microscope, 
the fecal substance is found to contain the hu-ks and cell- walls of 
vegetable aliments, the ducts of plants, portions of tendon, ligament 
and muscular fasciculi. Fatty matter and crystals of cholestrine 
4 






74 PHYSIOLOGY. 

from the bile are not uncommon. Starch is largely cast out, owing 
to defective methods of cookery which prevent its assimilation. 
This shows the mistake of nurses and others in feeding infants aud 
invalids with starchy substances, like tapioca, arrow-root, rice, etc. 
All the products of diseased aciion of the body are found in the 
faces; blood, pus, lymph, cancer, parasites. All these would be 
thoroughly disintegrated if the digestive function was in normal and 
active condition. Even tape-worm itself cannot live in healthy di- 
gestive fluids. Of the five ounces of solid matter daily expelled 
from the intestines of a healthy man, about forty-two grains are 
nitrogen. According to Liebig the true fecal matter is the product 
of imperfect oxydation or histogenet : c elements of the food while 
undergoing metamorphosis, preparatory to assimilation. There is no 
putrefaction in a state of health; the peculiar odor being from 
transformed bile. Offensive discharges seldom proceed from food ; 
colliquative diarrhoea, the most disgusting of any, is the sequence 
of exhausting disease. 

The disorders of this function are of various kinds. We have 
constipation, diarrhoea, tenesmus, dysentery, cholera, lienteria, and 
the unnatural color of the evacuated matters. Iliac passion is a 
more dangerous form. It proceeds from a mechanical obstruction 
of the intestine. The result may be an antiperistaltic action, forcing 
the contents of the tube backward even into the stomach. Animals 
are subject to this disorder. 

The impairment of the nutritive function is the cause of numerous 
pathological conditions. It has been common among medical 
writers to impute many of them to the blood. But the changes in 
the constituents of the blood, aud the diseases accompanying them 
are secondary. The primary cause is elsewhere, and should be 
sought by the medical practitioner. Indeed, we are not partial to 
the classifications which are made of diseases and morbid con- 
ditions. A more thorough knowledge of physiology will show that 
disease is a pathological condition, taking peculiar form from the 



ELEMENTS OF DISEASE. 75 

external influences which control the matter. It is a disturbance, 
an incidental variation from normal health, and little else. 

The sympathetic, ganglionic, or vaso-motor nervous system, we 
are of opinion, is the source from which most physiological and, of 
course, morbid action originates. The glands and blood-vessels are 
almost entirely subject to its control. The simple disturbance of 
circulation, known as congestion, or over-distension of the blood- 
vessels, especially the capillaries, is due to some shock or injury of 
these nerves, or irritation of the textures. It may be temporary ; 
but if long-continued will give rise to more formidable troubles. 
"When it is caused or accompanied by excitement of the nervous 
system, it produces fever. If this has been produced by some poison 
introduced through the blood, it is called primary, and may be 
intermittent, remittent, or continued. If it is produced from injury 
to texture or refl< x action, causing internal inflammations, it is 
styled secondary or symptomatic. 

When the congestion is caused by mechanical obstruction to the 
flow of blood through the veins, the serum transudes through the 
walls of the capillary vessels into the parenchyma and collects in 
various places, causing dropsy. If it is generally diffused in the 
parenchymatous tissues it is called anasarca; if limited to the chest, 
hydrothorax; if to the brain, hydrocephalus; if to the peritoneal 
cavity, ascites; if it is local it is denominated cedema. Its remedy, if 
any, is to be found in restoring the veins to activity to carry on 
their part of the circulation efficiently. 

Sometimes the capillaries are ruptured from being over-distended, 
and the blood is extravasated into the tissues. This is capillary or 
congestive hemorrhage. A disease of the coats of a blood-vessel, or a 
wound, will be fpllowed by extravasation. 

Active congestion, when it becomes excessive, is liable to terminate 
in the exudation of the liquor sanguinis through the coats of the 
vessels. This is inflammation— a state distinct from congestion or 
fever on one hand, and from dropsy or processes of growth on the 
other. This exudation undergoes a variety of changes, producing 



7C PHYSIOLOGY. 

various morbid conditions. When the liquor sanguinis, in a nor- 
mal condition, infiltrates the neighboring tissues, or collects in a 
serous cavity, like the thorax or abdomen, it coagulates and under- 
let s transformation in one way or other as follows: 1. It will form 
cells and fibres, and constitute an adhesive lymph as is often done 
on the surface of serous membranes. 2. It will evolve pus-cells, and 
so constitute suppuration, as on mucous surfaces and in areolar tex- 
ture. 3. It will develop granule- cells, and form inflammatory softening. 
4. It will form various tissues, fibrous, vascular, bony or cartilaginous. 
It will thus be absorbed, evacuated externally by discharge, or 
assimilated to the body. In this way abscesses are formed, wounds 
healed, divided tendons and bones united, etc. 

But when an exudation undergoes none of these changes, but 
assumes a yellow or grayish aspect, and a cherry consistency, it 
becomes tubercle. If it is di-seminated in small grains, it is denomi- 
nated miliary, but if in considerable masses, infiltrated tubercle. 
When chronic, it may be encysted, or present the form of a cedcareous 
mass. 

When an exudation passes into cells and fibers, the former in- 
creasing endogenously, it is denominated cancer. If hard or 
formed of fibers from associated morbid growth, it is called scirrhus; 
if soft, and yielding a milky juice on pressure, it is encephaloma ; 
if it has a fibrous basis, and contains a glue-like matter, it is termed 
colloid cancer. When the exudation is poured out in such quantity 
as to paralyze the nerves and obstruct the blood-vessels, it dies and 
undergoes putrefaction. This is gangrene or mort;fication. It is 
sometimes apparently epidemic. When the exudation presses upon 
the surrounding part"*, obstructing the flow of blood in them, the 
death of the parts takes place. They slowly disintegrate, and an 
ulcer is formed. The w« ight of depending parts, or the pressure of 
a foreign body will have the same effect. 

When an organ or structure is enlarged, the case is styled hyper 
trophy ; the thickening of membranes is denominated induration. 
When the calibre of a tube or duct is thereby diminished, it is 



OKGANIC DISEASES. 77 

stricture. The vital transformations of an exudation into pus, 
granule or other cells, constitute a kind of morbid growth. The 
healing process, giving rise to new tissues resembling those pre- 
viously exi ting, as in cicatrices, callus, etc., are vital transforma- 
tions. Sometimes the morbid growths take the form of tumor. 

There is also atrophy, or diminution of texture, albuminous degen- 
eration, fatty degeneration, pigmentary degeneration and mineral degen- 
eration. 

Concretions also occur in the body of non-organized bodies. These 
are generally mineral deposits, or aggregations of matter, and are 
most often found in the cavities, ducts and hollow viscera. They may 
be formed from albuminous, fatty, pigmentary or mineral structure ; 
but are distinct from degenerations in that they have not been formed 
from an organic structure. Urinary concretions are from the salts in 
the urine which have been precipitated around a central body or 
nucleus. Biliary concretions or gall-stones are formed of inspissated 
bile or cholestrine ; the latter being white and the other dark-colored. 
Intestinal concretions are composed of bodies that have been swal- 
lowed and accumulated around a central nucleus. Mineral concre- 
tions are composed of c irbonates and phosphates of lime, and are com- 
mon in the mucous passages of various organs, especially the sali- 
vary, pulmonary, pancreatic, hepatic and renal. They occur also 
in the veins. 

Such are the principal organic diseases. When the structure of 
the organ is not affect d, but the normal action is principally affected, 
the disord r is termed functional. The causes are to be sought in 
increased or di;nin : shed stimulation upon the tissues, increased or 
diminished excitability of the nervous system operating upon them, 
in an altered condition of the blood, or in transformation of texture. 
These causes may act separately or combined, and one may occasion 
the other. 

The Nervous System is the source of all vital phenomena. We live 
by virtue of its integrity; we perish when it becomes incapable of its 
office. All the functions which wc have enumerated are maintained 



78 PHYSIOLOGY. 

solely from this beginning and cease when communication with it is 
interrupted. The lungs will not respire, the heart will not pulsate, 
the blood will not flow, the glands will not absorb or secrete and the di- 
gestive apparatus will become dormant. It is not enough to tell of 
thought being suspended, the mind rendered incapable of action or 
of directing the movements of the bo ly. "We hold at secondary value 
the common references to the nerve-centres as the source of mani- 
fisiations. By these are meant the brain and spinal cord. Animals 
having no vertebral column, no brain and spinal cord, have never- 
theless a nervous system with functions and faculties. As that sys- 
tem may exist without the cerebro-spinal axis, ard is manifestly 
anterior to it, the conclusion is legitimate that it is the agent prim- 
arily of vital phenomena. 

This primary nervous system is denominated sympathetic, gangli- 
onic, organic, tri-splanchnic. As a general rule we employ the first 
and second of these terms; our principal reason being to avoid con- 
fusion. 

The sympathetic nervous system consists principally of ganglia, 
containing numerous nerve-eel's and communicating with each other 
by one series of connecting nerve-tubes, and with the cerebro spinal 
nerves by another. These ganglia are usually classified as consist- 
ing of 3 cervical, 12 dorsal, 3 to 5 lumbar and 3 to 5 sacral. In addi- 
tion to these are the two semilunar ganglia, three or four coeliac and 
one cardiac. There are also the ophthalmic, the spheno-palatine, the 
rife and the submaxillary ganglia, and likewise the cavernous and 
rtaso-palathie. There are also two others which are not usually 
recognized as such; namely, the pineal gland and the pituitary gland. 

The structure of these ganglia is different from that of the cerebro- 
spinal system. They present a soft, spongy tissue, somewhat re- 
Bembliog that of the lymphatic glands. The mass of the ganglia is 
composed of B plexus of nervous filaments, with a quantity of gray 
in urine. A thin body of areolar tissue surrounds each, and a lamella 
or vascular membrane analogous to the pia water which envelops the 
brain. 



FUNCTIONS OF NERVOUS CENTRES. 79 

Each of these ganglia is a distinct nervous centre and controls cer- 
tain functions of the body. Dr. O'Reilly has determined their func- 
tions by repeated vivise tiOns, as follows : 

The pineal gland regulates the functions of the brain, and by arrest- 
ing its action induces sleep. 

The pituitary gland regulates the nutrition and other physical 
functions of the brain. 

The carotid ganglion regulates the force of the circulation through 
the arteries of the brain. 

The lenticular ganglion protects the f unct r On of the eye, so as to 
meet the requirements of the mind. 

The otic ganglion is essential to the function of hearing, and regu- 
lates the action of the tensor tympanl. 

The spheno-palatine g 'nglion presides over the whole matter of 
eating, including salivation, mastication, deglutition — also drinking 
to allay thirst which arises from the presence of oxygen iu the blood 
in excess. 

The superior cervical ganglion presides over the function of the in- 
tonation of the voice, and also certain muscles to which it supplies 
branches. It also has some concern in the action of the heart. 
Yeratnim seems to influence the function of this ganglion. 

The middle cervical ganglion governs the action of the thyroid glands, 
several muscles to which it sends nerves and also takes part in the 
movements of the heart. 

The inferior cervical ganglion regulates the motions of certain mus- 
cles to which it sends branches, and also the mammary glands. 

The cardiac and pulmonary ganglia regulate the action of the heart 
and lungs. 

The semilunar, th" hepatic, the diaphragmatic, the splenic, Ihe 
gastric, the renal and the mesenteric, preside over the secretion of 
gastric juice and bile, the action of the diaphragm, the secretion of 
urine, the action of the small intestine, and the function of absorp- 
tion by lact'-al and lymphatic vessels. 

The spermatic ganglia preside over the secretion of semen. 



80 PHYSIOLOGY. 

The vertebral ganglia superintend the contraction and relaxation 
of the muscles. 

All these ganglia hold communication with each other, and the 
nerves derived from them are distributed over tlie body and connect- 
ed with those coming from the cerebrospinal axis. Thus there is a 
complete interlacement and inosculation of bothseis of nerves all over 
the surface of the body. 

In hydrophobia, the spheno p datine ganglion is morbidly affected. 
This ganglion sends nerves to the musd< s employed in deglutition 
and likewise to the arytenoid must le. Hence, the secretion of the pe- 
culiar saliva, the spasms and deaih ensuing from the non admission of 
air into the lungs. Yenoirous reptiles operate by the agency of this 
ganglion. 

Respiration, circulation and digestion are functions common to all 
animals, vertebrate and invertebrate. 

The nerves accompany the arteries to all the muscles and viscera. 
The supposition that the pneumogaxtric, or par vagum nerve, con- 
trols these functions is an error. That nerve may be divided with- 
out stopping either of these functions. Dupuytren could discover 
no morbid change in the lungs of a dog on the side on which it had 
been tied. Magendie observed that the muscular movements of the 
sti mach continued after the cutting of that nerve ; hunger was also 
experienced and digestion took place. 

T-ie contraction and dilatation of the iris of the eye, also of the heart, 
the arteries, the stomach, the intestinal tubes, the diaphragm and the 
womb, are all due lo the action of the nerves of the ganglionic sys- 
tem. 

The pineal gland, it is acknowledged, has not been classified with 
nervous organisms. Des Cartes, the philosopher, was tidieuled be- 
[i i conjectured thai it might be the seat of the soul. lie was 
;t- oesr truth as error, to say the least. In the experiments of Du 
Petit, the putting of the superior cervical gan-lin produced constric- 
tion of the pupil of the eye ; and indeed, that organ shrunk in size. 
These ate results incident to the irritation" of the pineal gland. The 



INJURIES TO GANGLIA. 81 

communication of the several ganglia is the explanation. A person 
may labor under chronic hydrocephalus, having his mental and vital 
faculties apparently unimpaired. There is no pressure of the gland 
or ganglion in question. But in case of meningitis, the gland suf- 
fers from irritation. The inflammation crowds the contents of the 
skull, and the serum effused presses upon the ganglion. The glisten- 
ing of the eyes, and contraction of the pupils, indicate the nature 
of the disturbance. The suffering of the ganglion is communicated 
to the other ganglia, impairing vita! ty through the entire sympathetic 
system, and finally extinguishing life altogether. 

An injury may be inflicted on the head, even severely wounding 
the brain, but so long as this gland is intact, there will be apparently 
no injury, either to the vital facul ies, or to the intellect. 

A blow directed to the pit of the stomach, will destroy life through 
violence to the semilunar ganglion, which is immediately communi- 
cated to the other ganglions, destroying life in Ihem all. A blow on 
the cardiac ganglion will destroy life in the same way. A blow on 
the upper cervical ganglion will produce death or suspended anima- 
tion. A blow on the centre of the forehead, will cause either death 
or susp; faded animation in consequence of the shock communicated 
to the pineal gland. 

In the invertibrate animals the several glands are occasionally so 
distinct that each is an independent nervous system. The animal 
may be cut in pieces and each piece live by i'self. 

"Now as to the sympathetic nerve," says Mr. Quain, "so far 
from being in any way derived from the brain or spinal cord, it is 
produced independently of either, and exists, notwithstanding the 
absence of both. It is found perfectly formed in acephalous in- 
fants, therefore does not arise mediately or immediately, from the 
brain ; neither can it be said to receive roots from the spinal cord, 
for it is known to exist as early in the foetal state as the cord itself, 
and be fully developed, even though the latter is altogether want- 
ing. It appears that whilst the organs of vegetation and life are 
being formed, the sympathetic nerves are produced concurrently 



82 PHYSIOLOGY. 

with them ; and that as the growth of these parts proceeds from the 
circumference to the centre of the whole body, from its lateral parts 
to the median line, the sympathetic nerves also conform to the 
general law." 

Nerves belonging to . the sympathetic system are given off and 
surround the arteries, extending to their various brandies and re- 
motest extremities. At these extremities, they take the form and 
appear to perform the functions of glands. This is indicated from ' 
the fact that the blood in the smallest artery is aiterial, and venous 
in like manner in the smallest vein. In leaving the artery then, the 
blood gives off its oxygen and becomes venous. This point, there- 
fore, is the place of the generation of animal heat ; it being a fa- 
miliar chemical law that the union of oxj-gen with any substance is 
attended by the evolution of heat. Electricity is also developed 
where heat is produced. 

In running, circulation is rapidly increased. As a result, respira- 
tion is hurried, and the blood loaded heavily with oxygen. The 
results are burning heat of the surface, and great thirst. If drink is 
taken, it is rapidly absorbed into the veins, carried to the lungs, and 
thence to the heart and arteries. The electricity decomposes the 
water as it leaves the arteries, the hydrogen of which unites again 
wiih oxygen in the blood forming water, which now makes its way 
to the skin as perspiration. 

When silver nitrate has been token for a long time these arteries 
and glands become contaminated with it; the venous blood carries 
the silver to the heart and lungs, where it receives oxygen. On re- 
turning to the heart, the blood is sent thence to all parts of the 
body. When the oxygen is absorbed at the glandular terminations 
of the arteries, the silver is also left there ; and on the deposit of a 
sufficient quantity, it becomes on exposure to the light, an oxide of 
silver which gives the skin a peculiar color. 

As at the termination of the capillary artery and the commence- 
ment of the capillary vein, the blood ceases to be arterial, and be- 
comes venous, and secretion also takes ph.ee, it in evident that a 



VITAL OPERATIONS. 83 

secernent organ intervenes. This organ or gland is formed of the 
termination of the artery and the commencement of the vein, and 
excretory duct, together with the nerves, which have extended from 
the ganglion alon;? the coat of the artery. 

The pulmonary artery is in like manner surrounded with veins 
from the pulmonary ganglion. These are continued on all the 
branches of the artery to the capillaries, where they form glands. 
Through these glands the blood must pass to reach the pulmonary 
vein. 

These glands are in close communication with the air-cells, which 
are analogous to the pores of the skin. They communicate with 
the inhaled air, and so the analogy is still more complete ; for the 
glands in the skin are in communication with the air from without. 
As soon as the air comes into contact with the organic glands in the 
air-cells of the lungs, the glands are stimulated and give off elec- 
tricity. This causes the oxygen of the air to unite with the blood and 
arterialize it. The heat thus evolved also produces electricity by 
which the carbon and hydrogen are expelled. 

The blood is second in importance only to the sympathetic sys- 
tem. It is the current of life. It carries oxygen to the glands and 
furnishes material for the renovation of the various organs, under 
the influence of the vital action of the ganglionic nervous system. 

Oxygen takes rank next. By its union' with the glands and blood, 
as before shown, the operations of life are manifested, — respiration, 
circulation and animal heat. The cessation of respiration is attended 
with the suspension of animation, and death. Vigorous respira- 
tion is accompanied by increased action of the heart, and a higher 
temperature of the surface of the body. Whatever weakens the 
respiration, weakens the action of the heart and reduces the tem- 
perature. As respiration is the effect consequent upon the evo- 
lution of vital energy or electricity by the pulmonary glands, it 
follows that whatever depresses or excites the sympathetic nervcus 
system, weakens or strengthens respiration. 

We notice this exemplified in medical treatment, also in shocks 



84 PHYSIOLOGY. 

from fall or other injury. A patient laboring under fever and 
difficult breathing is often relieved by drugs of a depressent character. 
The circulation is reduced and there are modified symptoms. It is 
because the lungs have been rendered less able to take in oxygen; 
and so the venous character of the blood is less changed. Patients so 
treated never recover strength rapidly. 

A man struck at the pit of the stomach or on the superior ganglion 
of the neck will fall to the ground, animation being more or less sus- 
pended. The shock given to the ganglion is communicated to the 
pulmonary, as well as to the other ganglia, and the result is an 
inability to evolve vital force, to unite the oxygen with the blood. 
The inhalation of ether or chloroform will paralyze the pulmonary 
ganglion. A man falling from a height will be found apparently 
lifeless, the countenance pale, respiration imperceptible, the pulse 
feeble if not entirely gone and the surface rapidly becoming cold. 
The shock in this case has involved the entire sympathetic system; 
the pulmonary glands are unable to act and life is suspended for 
want of oxygen. In case of immersion under water, a like effect is 
produced. 

Death ensues from exhaustion because the pulmonary gland can- 
not evolve vital force to oxygenate the blood. In the event of hem- 
orrhage, the glands endeavor even convulsively to support life, but 
the supply of blood is cut off and animation is thus suspended. 

The inosculation of the nerves of the sympathetic with those of the 
cere bro spinal system has been mentioned. As a sequence there is a 
constant reciprocity of action between them. When grief or anx- 
i- ty harasses the mind, the sympathetic system participates in the 
trouble. There is a painful sensation in the region of the heart and 
mora conspicuously an oppression felt at the pit of the stomach. All 
this i> the result of the communication between the pineal gland or 
ganglion and the br inches of the pneumogastric nerve, which inoscu- 
late with the branches of the solar plexus and the cardiac plexus. 

Upon the hearing of bad news ihe pineal gland receives the shock 
and communicates it to the semilunar ganglions, the cardiac and pul* 



THE SYMPATHETIC SYSTEM. 85 

monary ganglia, to the renal and spermatic ganglia. The effects 
are palpitation of the heart, suspended animation, loss of appetite, 
involuntary evacuations. A pregnant woman is very liable to abort 
or miscarry. 

A copious secretion of saliva takes place when a hungry person 
comes in the vicinity of attractive food. The lachrymal gland will 
pour out a copious supply of tears on the occurrence of any event 
causing grief. The breasts of the mother fill with milk at the appear- 
ance of her babe after a brief absence. The nipples of a woman 
will dilate and enlarge at the approach of the man whom she esteems. 
A piece of bad news will make the face turn pale. A disgusting 
story or spectacle will induce vomiting. Di>turbance of the mind 
by the rapid shifting of objects in sight will also cause the stomach 
to contract and expel its contents. All these phenomena result from 
the intercommunication of the cerebral nervous system with the 
sympathetic. 

Pneumonia or pneumonic fever is occasioned by great depression 
of the sympaihetic nervous system, generally from exposure to cold. 
Reaction occurs, and is soon followed by irritation, which establishes 
itself in one side of the lungs. When cold has affected a part for some 
time, the reaction will enlarge the capillary arteries, increasing the 
supply of blood and oxygen at the place. The nerves endeavor to 
relieve themselves by throwing off the offendiug matter in the form 
of lymph and pus. Thus we have phlegmon. 

The application of animal poison to the glands at the extremity of 
the capillaries, is followed by excitement of the nerves, enlargement 
of the vessels, larger flow of arterial blood, and increase of tempera- 
ture. The parts are endeavoring to expel the poison by the effusion 
of lymph and pus. Syphilis, vaccinia and analogous disorders have 
this mode of diffusion and action. 

Contagion and m" aria enter the lungs, and poison the whole sym- 
pathetic nervous system. Typhus, typhoid and intermittent, owe 
their inception to the inhalation of decaying vegetable or animal mat- 
ter. Phthisis is accompanied with a poisonous emanation from the 



86 PHYSIOLOGY. 

lungs and surface, capable of infecting others. Erysipelas, hospital 
gangrene, and puerperal fever are disseminated from noxious princi- 
ples In the atmosphere. They cause depression of the sympathetic 
system, followed by excilement and the various other symptoms. 

The sympathetic nervous system is not under control of the mind 
or will ; but is acted upon by it under unusual circumstauces. When 
the internal organs are the seat of disease there appears to be pain, 
even severe. The filaments of the cerebro-spiual system pas-ing 
through the ganglia and inosculating with the nerves are probably 
the explanation. The ganglia, however, not only receive and dis- 
tribute impressions coming from and sent to the cerebro-spiual 
"nerve centres,'' but they are nerve-centres themselves, and especially 
centres of numerous reflex acts in non-voluntary muscles. 

In addition to this excito-motory function, the sympathetic system 
is, as we have shown, (xcito-mcretory. It acts upon and influences 
the glands, as well as the blood-vessels and nutrition generally. It 
has little effect on wounds of the lower extremities to cut the crural 
and sciatic nerves, but injury to the ganglia of the sympathetic is 
sure to exercise the most destructive influence on the nutrition of the 
part 

Cutting of the sympathetic nerve will cause paralysis, relaxation 
and congestion ; and we may thence inter the disorders produced by 
any impairment of its functions. 

Fevers begin with a feeling of cold followed by an increase of 
heat, indicating irritation and then paralysis of the sympathetic 
system. In inflammation, there is also a lesion of the excito nutrient 
or rxiso-motor nerves, which causes an exudation from the blood ves- 
sels. In cholera, there is a prolongation of the cold stage ; hence 
the pallor and blueness of the surface, the congestion and enormous 
discharges from the gastric and mucous membranes. These exam- 
ples may be multiplied, but enough has been shown to prove the al- 
most general agency of disorder in the sympathetic system of nerves 
in inducing disease. It shows also, that the numbering and clas-i- 



THE BRAIN AND SPINAL NERVES. 87 

fying of diseases cannot be much depended upon ; we have to deal 
rather with derangements and morbid conditions of the economy. 

It follows then, to :tdopt the words of John Hughes Bennett, that 
the functions of the sympathetic system are : 1st, Excito-motory, 
thereby regulating the contractions of the non-voluntary muscular 
fibres; 2d, Excito -secretory, whereby the various secretions are 
governed; 51 d, Excito-natrieni or vaso-motor , operating more especially 
on the blood-vessels, and thereby regi dating the circulation in the 
capillaries, and the amount of animal heat. 

It is manifest therefore, that we have not exaggerated the import- 
ance of this nervous system in the vi:al economy. 

The ccrebro-spinal axis, however, has most attracted the attention 
of physiological students and explorers. This system includes the 
cerebrum, or larger brain, the cerebellum or lesser brain, the corpus 
callosum, corpora striata, optic thalami, corpora quadrigemina, pons 
varolii, medulla oblongata, and medulla spinalis. All these are en- 
cased in the skull and spinal column; and by virtue of this endow- 
ment the animals are denominated vei tebrates. The skull enclosing 
the upper extremity of the cerebro-spinal axis, is after all, upon 
close examination, but an extension of the vertebral column. A 
rivalship existed between the surgeon-poet, Goethe, and the natural- 
ist Oken, as to which was the first to remark it. It was original 
with both, and appears to have taken place almost simultaneously. 

That the essential life, the biological principle, is manifested in the 
gr< at sympathetic nervous system, has been distinctly asserted and 
set forth. But the cerebro-spinal system is the organ of a superior 
vitality, dependent on the other for a basis and existence, but 
transcending it in scope and powers. By virtue of it men see, hear, 
feel, think, reason, attain to intellectual conceptions and moral 
faculties; in short, are made capable of becoming spiritual, rational, 
moral beings. Whether, however, any race except the human pos- 
sesses this capacity is more than doubtful. The various vertebrate , 
animals appear to typify the human ideal, but not to attain it. 

The sul»stance of which the brain is composed is denominated 



88 PHYSIOLOGY. 

murine. There are two forms of it, the gray or ganglionic, and 
the white or tubular. A close examination of the gray matter 
shows it to be abounding with blood vessels, and to consist princi- 
pally of molecular matter, in which are embedded nuclei and 
nucleated cells, of different sizes and shapes, connected together by 
nerve-tubes of various calibre. The white matter is essentially 
tubular, and less vascular than the gray. Some of the tubes run 
into the corpuscles of the gray substance and others originate there. 
Every ganglionic cell in ihe gray matter receives and gives off these 
nerve-tubes, each having distinct properties — the one of conveying 
impressions to the nerve-centres and the other of carrying influences 
from them. 

The brain is largely and equally supplied with blood by the 
basilar artery, which is formed by the junction of the vertebral 
arteries and the internal carotids. The branches of these arteries 
form a most remarkable anastomosis known among anatomists as 
the Circle of Willis. 

The cerebrum appears to view covered with the gray matter, 
which has been very properly designated the hemispherical ganglion. 
It presents on the surface numerous breaks, ridges and fur- 
rows or sulci ; by means of which a large amount of matter is 
capable of being contained in a small space, and a great surface 
may exist in a limited region. In the other contents of Ihe skull ihe 
gray matter exists in masses, and constitutes a chain of ganglia at 
the base of the encephalon. These are more or less connected with 
each other and with the medulla spinalis. In this part of the 
structure the irrav matter is internal and the white nervous substance 
exterior, reversing the order in which it is found in the skull. 

The white tubular substance of the spinal cord is divided into 
three columns on each side. The anterior and posterior horns of 
gray matter and the anterior and posterior sulci on each side are 
the divisions. The posterior columns constantly decussate through 
the length of the cord. The others ascend the vertebral columns 
to the medulla oblongata and these decussate with each other. 



INTERCOMMUNICATION. 89 

The posterior column passes to the cerebellum. ; the others enter the 
other portions of the brain and finally are lost in the white sub- 
stance of the cerebrum. So there is direct nervous communication 
between the various bundles of tubes, the gray matter of the spinal 
cord, the spinal cord and the brain itself, and between the spinal 
| cord and the nerves of the body. 

The cerebrum itself has also bands of transverse tubules which 
bear the name of commissures, and connect its two hemispheres. 
The anterior and posterior lobes are connected in like manner. It 
therefore is connected in all its parts, and joined intimately with the 
other portions of the cerebro-spinal axis. It has also been ascer- 
tained that the tubes of the nerves are connected, and indeed actu- 
ally terminate in the gray matter of the spinal cord. The nervous 
actions are transmitted by these tubules running in different direc- 
tions.. Many of these are usually denominated reflex, but this is a 
misnomer. They are direct, passing and operating through the 
spinal cord, and are therefore diastaltic. 

The difference in structure between the gray and white nervous 
matter has led to the opinion that they perform different functions. 
It is believed that the gray matter evolves nervous energy, and that 
the white conveys to it and from it the influences that are sent 
thither or originate there. It is not supposed to be without the 
power itself of originating, but conductivity is believed to be its 
chief function. 

The brain, it is certain, furnishes the conditions necessary for the 
manifestation of the intellectual faculties properly so called, of emo- 
tions, passions, volition, and sensation. 

It has been observed in the animal worl 1 that there was a very ex- 
act correspondence between tin sagacity of the animal and the 
qutntity of the gray matter, and the depth of its convolutions. In 
young infants the grny matter is deficient ; there can handy be said 
to be any convolutions, but only superficial fissures to indicate th; ir 
place. As this substance increases, the mind and intellectual facul- 
ties become developed. It has been observed on slicing away the 



90 PHYSIOLOGY. 

gray matter from the brain of animals, the result was dullness and 
stupidity. In diseases affecting the brain, those beginning at the 
surface and proceeding toward the centre, affect the mental faculties 
first ; whereas, in diseases commencing at the centre, the mind is last 
to be affected. 

The white tubular matter conducts the influences originating in 
the hemispherical ganglion to the nerves of the head and trunk, and 
they in turn convey them up to the cerebral convolutions. The fibres 
which connect the two hemispheres of the cerebrum, doubtless serve 
to combine the mental faculties for the production of thought 

The gray matter of the spinal cord, is connected with all the motor 
nerves, the nerves which obey Ihe will. It is in larger masses at 
those places of the cord where the large nerve-trunks are given off. 
The lower part of the cord also has a far larger proportion than the 
upper part. It is also collected in the lower animals, at the points 
where nerves are supplied to organs requiring a large quantity of 
nervous power, like the electrical fishes. Where the central portion 
of the cord is affected previous to the external portion, an individual 
retains the power and sensibility requisite to moving the limbs. • But 
he cannot stand, walk, or keep himself erect, especially when the 
eyes are shut. If the disease begins at the meninges of the cord, or 
externally, the first symptoms are pain, twitchings, spasms, numb- 
ness and even paralysis. All these, it is hardly necessary to explain, 
are results of the lesion of the white conducting matter. 

The nerves of the body consist of nerve-tubes running in parallel 
lines. They are indee 1 fascicles or little bundles of fibres, often of 
different function and office, surrounded by a common envelope 
designated m urilemma. Some of these, however, contain ganglionic 
c rinisclcs, as the olfactory, and the ultimate expansion of the optic 
and auditory nerves. The sympathetic nerve not only contains ganglia 
: t various places, but gelatinous flat fibres. There is a ganglion 
also hi the posterior roots of each of the spinal nerves. These roots 
are connected with the posterior horn of gray matter in the cord, 
while the anterior roots are connected with the anterior horns. 



SENSIBILITY. 91 

There are five classes of nerves, as enumerated by physiologists: 
1. Nerves of Special sensation, as the olfactory, auditory, optic, 
lingual and pharyngeal nerves. 2. Nerves of Common sensation, as 
the fifth pair and the glossopharyngeal nerves. 3. Nerves of 
Motion. 4. Sensory-motor nerves, where both kinds are included in 
one sheath. 5. Sympathetic nerves — already explained as consti- 
tuting essentially a distinct nervous system. 

There are also nerves whose functions are not included under these 
heads. The sensation of tickling, the perception of cold and heat, the 
consciousness of pain, the sense of weight, the perception of sex, are 
distinctive and are probably conveyed by distinct tubules. 

Sensibility is a peculiar property inherent in all nerves, in virtue of 
which, when they are irritated, a something is produced which we 
call an influence, that is conducted in various directions, according 
to the peculiar function of the nerves affected. Some carry the in- 
fluence in one direction, some in another. Some nerves can be excited 
only by one kind of irritant, others by another kind. The nerves of 
common sensation will be excited by ali kinds of mechanical irritants; 
the optic nerves are excited only by light and the auditory nerves by 
sound. If the influence is conveyed to the brain, various sensations 
are produced; if to contracti'e parts, we have various kinds of move- 
ments; if to the glands, varied sensations; if to the tissues, varied 
alterations in growth. The nerve, unlike a metallic conductor, gen- 
erates as well as conducts its peculiar influence. Sensibility however 
analogous to physical phenomena, is nevertheless broadly distinct 
from them. It is only to be recognized as a characteristic of living 
beings and therefore as being essentially a vital function. 

The rapidity of the nerve-current is largely affected by tempera- 
ture. It is increased in the motor nerve ns the litter approaches 
tbe muscle. The velocity of impressions does not appear to be as 
great as has been supposed. Probably it is not greater than 150 feet 
per second. 

Sensation is properly defined as the consciousness of an impression; 
and it requires for its production a stimulus applied to a sensitive 



92 PHYSIOLOGY. 

nerve, an influence generated in consequence and conveyed along the 
nerve to the hemispheric ganglion and the action of that faculty of the 
miud denominated perception or consciousness. It may be destroyed 
by anv circumstance which disarranges either of these operations, the 
destruction of the sensibility of the nerve, the impeding of the pro- 
cess of conducting the impression or the unconsciousness of the mind. 
Examples are familiar to every body. 

Motion is performed through the agency of muscles endowed with 
the peculiar vital property designated contractility. They are en- 
dowed with this property in the same way that nerves are endowed 
with sensibility. This function may be called into action by agen- 
cies independent of the nerves, and also by physical or psychical 
stimuli operating through the nerves. Pricking, pinching, galvan- 
ism, etc., will induce convulsions. The will and certain emotions 
will call the contractile force into action. Integrity of the muscular 
structure is sufficient for contractile movements ; but the spinal cord 
and brain must also be in normal condition to instigate and direct 
them. 

The functions of the brain as a psychical and mental agent and 
organism have engaged the study of metaphysicians and physiolo- 
gists for two thousand years. It was usual formerly to refer these 
to the vixccra, notably to the "nobler intestines." In the Assyrian 
Tablets the heart and the liver are indicated as the seat of emotion. 
The Hebrew Scriptures are forcible in delineat'ng the heart and the 
reins. In grief the bowels were represented as making a noise as 
from disturbed action. The reins were disquieted. Sensation, 
emotion and affection are imput d to the heart. Thus Dr. Noyes 
renders ,/, r< miafl xv'.i : 0, 10, where the figure is employed 
" The heart is deceitful above all things ; 
Yea, it is corrupt ; Who can know it ? 
I, Jehovah, search the heart 

And try the reins, 

To give to every man according to his ways 

And according to the fruit of his doings." 



MENTAL FACULTIES. 93 

Galen seems to have been of opinion that the brain rather than 
the viscera, represented the mind and its emotions. Plato also de- 
clared that the understanding, which is the most sacred part of 
man, is in the head. But modern investigators, who claim that 
science must be mathematical and exact, have been very dilatory in 
their investigations of the subject. The pathology of insanity is 
little known. Many who would pass for scientists are contented 
with giving to phenomena certain names and then treating the 
names as actual explanations. But they are seldom diffident or 
moderate in denouncing those whose researches have not been after 
their method, or with like results. Psychology as the term is used 
by medical men is a misnomer. As scientific it is superficial ; and 
indeed it is only remarkable for not relating to the soul. 

It may be considered as certain that the gray matter, the cortical 
layers of the brain, furnish the conditions which are necessary for 
thought, and all mental operations. Dr. Thomas Brown classified 
mental phenomena as the external affections and the internal affections. 
Under the former he included the sensations ; under the latter the 
intellectual and the emotional states. The intellectual states com- 
prise simple and relative suggestions ; the emotional, the passions 
and desires. 

It is more convenient however to divide the mental faculties into 
three kinds ; the purely intellectual, the sensations and volition. The 
prominent intellectual faculty is consciousness. This constitutes our 
ego, the idea and conception of our own existence. Influenced in vari- 
ous ways, it causrs, evolves, and inspires the other mental facul- 
ties. If directed to the present it is perception ; if to the past, it is 
memory. If it suggests the ideal, it is imagination ; if applied to 
thought synthetically, it is generalization ; if analytically, it is reason- 
ing. If it originates ideas intuitively, it is the faculty of original 
conception. 

The sensations are physical and mental, the former are touch, taste, 
smell, hearing, sight, the sense of weight, the sense of temperature and 
the sense of sex. The mental sensations are love, hate, desire, aver- 



94 PHYSIOLOGY. 

sion, hope, fear, joy, sorrow, audacity, despair, courage, etc., — also 
self-love, vanity and the moral f culty, the sense of right and 
wrong. 

Y<» it ion is the faculty of will. The affection known as will or in- 
clination is doubtless the primary principle ; its energetic action is, 
however, best known under that designation. Will formerly denoted 
the inclination of the mind; it now means its purpose. Directed to 
the muscles it produces voluntary motion ; to the senses, attention ; to 
the thought, abstraction or concentration of ideas. 

Under this classification, it will be s en, all cerebral function re- 
lating to mental operations, is fully comprised. The endeavor has 
b( en made, however, with great plausibility and we think very good 
reason, to arrange the mental and cerebral faculties under specific 
divisions. The science or method has received the designation of 
phrenology; and its inception and order must be credited to Drs. Gall 
and Spurzheim of Germany, and Dr. George Combe of Scotland. 
Their first efforts were of necessity empirical ; but in the minds of a 
large proportion of our reading population, the results are mainly 
coriect. We have never been quite assured of the soundness of all 
their propositions, and our respect for them suffers materially, 
because phrenology, perhaps like the practice of medicine, is taught 
rather as a trade than as a science. 

The brain, in this arrangement, is duly mapped out into regions. 
The basilar, comprising the cerebellum and adjacent parts, is assigned 
to the *< I fix 1 ', propensities and includes such functions as amativeness, 
phtioproffenit&oeneM, or love of children, inhabitivencss, or home-love. 
At the sides of the head are the regions of selfish sent inn nis, which are 
indeed pretty decidedly also propensities; such as alimentatkeness, or 
appetite for food, destructiven ss or disposition to destroy or put 
aside from sight and mind whatever is repugnant, vitatireness or 
tenacity of life, combativeness or disposition to contend, secretiveness 
or disposition to hide and guard, acquisitiveness or passion for 
accumulation. In the front are the intellectual faculties, embracing 



PHRENOLOGY. 95 

the frontal lobe of the cerebrum ; of which those beneath are de- 
nominated perceptive find those above them reflective. The former 
are individuality or the power of knowing external objects ; form, 
by which we take cognizance of forms j size, by which we 
perceive dimension ; weight, enabling us to estimate weight, 
density, resistance, etc. ; color, the power of perceiving 
colors ; locality, the faculty of local memory ; order, the love 
of methodical arrangement ; time, the faculty that enters into specu- 
lations on duration ; tune, the perception of musical tone ; number, 
the power of calculation ; language, the faculty of learning artificial 
signs of ideas ; eventuality, or memory of events ; mirtlifulness, or 
perception of the ludicrous ; imitation, or the faculty to perceive 
and imitate the peculiarities of persons and objects. 

Under the head of reflective facult'es are causality, the power of 
tracing cause and effect ; and comparison, or the faculty by which we 
recognize likenesses, differences and analogies. 

The top-head in which Plato located the more spiritual, diviner 
entity, is very appropriately set a; art to moral and religious senti- 
ments. "We have veneration, or the faculty to venerate and worship ; 
rnarvellousness, the disposition to believe ; hope, the tendency to ex- 
pect better things ; firmness or determination, conscientiousness or 
the disposition to be and do right ; cautiousness, or care to avoid peril ; 
self-esteem, or satisfaction with oneself ; approbativeness, or vanity, or 
passion for the favorable regard of others ; benevolence, or kind dis- 
position ; ideality, or the faculty to perceive and imagine the good 
and noble ; etc. t 

It is true that a person with lofty head is characterized by the 
noblest qualities that are possessed by men. A prominent forehead 
denotes the faculty of observation, study and research ; a broad 
skull over the ears indicates cruelty ; a heavy backhead, a sensual 
temper and strong will-power. But there are exceptions as marked 
as the rule ; and we are compelled to adopt the conclusion that the 
localization of the faculties has not yet been properly accomp'ished. 
The data have been carefully arranged, and appear very ingenious as 



96 PHYSIOLOGY. 

well as injurious ; but the great majority of facts educed by physio- 
logical and pathological research, do not support phrenology. The 
future may do better ; we apprehend phrenology has had its day. 

The cerebellum is materially different from the cerebrum in struct- 
ure. It is composed of white tubular neurine at the centre, 
bounded by a granular layer, outside of which is a row of nerve- 
cells with branches extending toward the molecular layer which 
constitutes the exterior. The texture is evidently molecular, con- 1 " 
taining numerous capillaries derived from the vessels of the 
meninges. Hence meningeal inflammation always involves the 
functions of this brain. Diseases of the cerebellum, such as ex- 
travasations of blood into its substance, softening, tumors, tubercular 
deposits, are accompanied by paralysis or convulsions. They are 
very violent frequently when the lesions are trifling, and slight when 
the whole or the greater part of the organ has been completely dis- 
organized. 

According to Dr. Gall, the cerebellum is the seat of the sexual 
instinct ; perhaps, but in cases where the organ was atophied, 
there appeared no diminution in that respect. The same remark 
must be made in regard to the statement that it is the organ of 
co-ordinated motion. Though a large backhead generally is ac- 
companied by active sexual impulses, the sign is physiognomical as 
far as we know, rather than functional. 

The ganglionic bodies known as the optic thalami and corpora 
ttriata are however very closely related to this function of co- 
ordination of motion. In t\\e event of disease on one side, hemi- 
plegia occurs on the other side of the body. The sense of sight and 
faculty of sensation are also affected. 

The optic tubercles or corpora quadragemini appear to have like 
relations to the f-ense of vision. Their removal paralyses the irides 
of the eyes ; as in fact do lesions of the optic tracts, the cerebellum 
(Mr the optic thalami. Wounding will also be followed by convul- 
sive movements. 

The medulla oblongata appears, however, to be most essential to 



THE MEDULLA OBLONGATA. 97 

life. It is the centre from which proceeds the necessary power for 
maintain ng the co ordinate movements of respiration and degluti- 
tion. Here occur also the decussation of the anterior and middle 
columns of the spinal cord, to which is attributable the crossed 
action of lesions of the cerebral lobes — apoplectic extravasations, 
softenings, etc., < f the right hemisphere of the brain, causing hemi- 
plegia of the left side, etc. Destruction of t!.e medulla oblongata 
causes sudden death ; but the removal of the entire brain -substance 
alone docs not. The vertebral portion of the spinal cord may also 
be removed up to the phrenic nerve, without destruction to life. 
But when the medulla is injured life and res[ iration cease at once. 
Hence skilful hangmen, it is said, endeavor to cause dislocation of 
the first or second cervical vertebra, so as to cause immediate death. 

In modern classification, all the contents of the encephalon, ex- 
cept the cerebrum, are denominated the spinal cord. The vertebral 
portion differs materially in structure from the cranial. The latter 
has been described and a cursory notice taken of the form r. 

The anterior roots of the spinal nerves are motor, and the posterior 
roots sensitive. In disease cf ihe gray central substance, the power 
of combining or co-ordinating movements is lost. This is progressive 
locomotor ataxia. Sometimes this affection is combined with atrophy 
of the muscles. It is a consequence of sexual excess, especially of 
masturbation. Diseases of the membra e enveloping the cord in- 
du e pain, spasms, tetanus, ttc. A section of one-hall the vertebral 
cord will produc ; epilepsy. 

The cerebro-spinal system has a therapeutics of its own. Such 
remedies as t a. coffee, opium, chloral act on the cerebral functions 
to exci e or diminish them. Strychnia, hemlock, calabar bean and 
tobacco excite or diminish the spinal functions. Cold v alcohol, hy- 
drocyanic aci 1 act on both. Some of these substances, it is w< 11 
known, are an^gmistic of others. Coffee will antidote opium ; 
c.dabar bean is adverse 10 atropia, and chloral will suspend the 
spasms and preserve life after fatal doses of strychnia and the cala- 
bar b an. 



93 PHYSIOLOGY. 

The cerebrospinal nerves as enumerated by Willis consist of 9 
cerebral and 31 spinal pairs of nerves. All the cerebral nerves, ex- 
cepl the olfactory, maybe regarded as belonging to the cranial portion 
of the spinal cord. The olfactory contains both gray and white mat- 
ter, and so is rather to be considered a ganglion than a nerve. Its 
function is to produce the special sensation of smell. 

The second pair, the optic nerves, receive and transmit the influ- 
ence of light. A portion of the filaments are decussated, so that the 
influence is given at once to both sides of the body. 

The tliir«l pair are the motor nerves of the eyeball, which regulate 
the principal movements of the eyeball. When irritated the result 
is spasm of the muscle and dilatation of the pupil. Their division 
produces strabismus or squinting, paralysis of the levator palpebra 
mu-cle, so as to keep the eyelid closed over the eye, inability to turn 
or lit the eye, and paralysis of the iris. 

The fourth pair, the trochlear nerves are also motor, and govern 
the trochlearis or superior oblique muscle of the eye. Division of 
this nerve products double vision; one object being apparently 
placed above the other. 

The fifth paii-, the trifacial nerves are among the most important 
of all the cranial nerves. They divide into three branches, two of 
which are purely sensory and one motor-sensory. The branches of 
this nerve blend and inosculate with those of the eighth and ninth 
pars, and also with the branches of the great sympathetic. The sen- 
sitive branches terminate in the face and communicate sensibility to 
toe skin, var ous organs of the head, and to the external parts of the 
several organs of special sensation. It is the great excitor nerve of 
those parts. Injury to it will blur the eye, dull the sense of hearing, 
affect the smell and taste; and also interfere with the various secre- 
tory and nutrient functions. An irritation or slight disease of this 
nerve will give rise to that severe pain known as neuralgia, and that 
viohnt form called tie douleureux. This is almost invariably caused 
by disorder of the stomach and yields when that is corrected. A di- 
vifioo of this nerve or destructive disease causes a paralysis of sensi- 



THE TRIFACIAL NERVE. 99 

bility of the face exactly defined by a line drawn through the middle 
of the forehead, nose, mouth and chin. The prick of a pin will give 
no pain, sternutatives in the nostril will not be felt, food placed in 
the mouth on the affected side gives no idea of its presence. In the 
endeavor to drink, the vessel will seem to be cut away at the part to 
which the paralyzed lip is applied. 

The jaws are also supplied from the non-ganglionic branch. The 
disease of the teeth will occasion excruciating pain, often extending 
and affecting the nerves of other teeth, and the side of the face. If 
the motor nerves are also paralyzed, the muscles which move the jaw 
find it difficult to perform their office, and mastication is impeded. 
The individual can chew only on the healthy side, as the action of 
the masseter and temporal muscles is also more or less affected. 
There is distortion of the countenance or loss of command over ex- 
pression ; which, indeed, appears to be governed rather by the 
sympathetic nerves. The jaw however is a little depressed. But 
this form of paralysis seldom exists alone. It is associated with 
hemiplegia, and also with the palsy of th& facial nerve; in which case 
the whole side of the face is paralyzed. 

So closely is this nerve associated with the nerves of special 
sensation as to have induced the supposition that all the special 
senses were dependent on the integrity of the fifth pair. This is not 
quite true ; but it is certain that these nerves are necessary to facili- 
tate secretion in the mucous membranes ; and the obstructions from 
the drying of their surfaces and consequent inflammation, ultimately 
destroys the senses of smell, sight, hearing and taste. Hence too 
great care can scarcely be taken to preserve the fifth pair of nerves 
in health and integrity. 

The sixth pair, the abducent, are motor, and govern the motion of 
the rectus muscle of the eye-ball. When it is compressed, divided or 
disorganized that muscle is paralyzed and the eye turned outward. 

The nervous power required to maintain the sense of vision is 
thus suggested. The apparatus is the most complex perhaps in the 
body ; and the function one of the most important. The great sym- 



100 PHYSIOLOGY. 

pathetic has a special ganglion, the ophthalmic, to maintain the 
vital force. The trochUairi*, abducent and third pair are all provided 
to keep the muscies, lids and eyeballs themselves in place and sub- 
ject to the slightest impulse of the will. The optic nerve exercises 
the sense of light, and branches of the fifth pair supply that ex- 
quisite sensibility which enables the brain to receive instant impres- 
sions and so act rapidly upon them. 

The privation of the sense of vision by reason of blindness, re- 
sults in throwing the nervous energy upon the general system. The 
blind display more passional tendencies, are more ungovernable in 
temper, easy to acquire habits of drunkenness and sensuality. Much 
may be attributed to morbid hereditary tendency. Few are born 
blind whose parents have not sinned. The vice of licentiousness is 
periiaps the principal cause. We discourse of scrofula ; but it is 
often but the harrowing sequence of the other. Persons made 
blind from such inheritance are likely not to be otherwise favorably 
organized. But the nervous force provided for the eyes, by so 
many nerves, if not so employed, is diverted into other channels 
and wid manifest itself accordingly. The physician and the patholo- 
gist will do well to bear this in mind. The treatment of the blind 
should be intelligent. 

The seventh pair of nerves is double in function and actually 
should be classed as two distinct nerves. One of them, the facial 
n< n\ is motor, and governs the movements of all the muscles of the 
face. We have already shown the effects produced by paralysis of 
this nerve. The expression of the lace is lost , the mouth is oblique 
and the paralyzed side appears hard and smooth, the eye enlarged 
and the lids open. The muscles moving the jaws are still obedient, 
because their nerves are from another source. The lips are para- 
lyzed and sometimes let saliva and food escape from that side of 
the mouth. Words containing labial letters are imperfectly pro- 
nounced. Expectoration is awkward. 

The other nerve, the atiditory, is the agent transmitting sound to 
the brain. Its extremity is expanded into a membranous network in- 



THE PNEUMOGASTRIC NERVE. 101 

vesting the entire internal ear ; so that the vibrations of the air im- 
pressing the tympanum, and transmitted by the ossicles of the 
middle ear, are impressed upon the auditory nerve and transmitted 
to the brain. 

The eighth pair has in like manner, three branches ; the glosso- 
pharyngeal, a nerve of sensibility distributed to the pharynx and 
root of the tongue ; the par vagum or pneumogastric, and the spinal 
accessory, a nerve aiding respiration, controlling the sterno-mastoid 
and trapezius muscles, and regulating the action of the larynx. If 
divided in the cranium, the voice is lost ; showing that this nerve 
rather than the vagus or pneumogastric regulates phonation. 

The pneumogastric nerve is both motor and sensory. Its branches 
are numerous and its functions diversified accordingly. It also anasto- 
moses freely with the sympathetic system, and so contributes to the 
vital as well as other operations. Its branches extend to the pharynx, 
the larynx, the oesophagus, the lungs, heart, stomach and diaphragm. 
In case of lesion of one of the pulmonary branches of this nerve, 
little effect is noticed ; but if both are cut, severe asthma and 
dyspnoea ensue. The lungs become congested and the bronchi filled 
with serous fluid. A paralysis of the nerve or any interruption of 
its action is likely to produce similar results. A division of the gas- 
tric branch will produce vomiting and loathing of food and retard 
the digestive process. The contractions of the stomach are also 
weakened, but as the semilunar ganglion of the great sympathetic 
rules the organ, the secretions are not affected. 

The ninth pair of nerves, the hypoglossal is the motor of the 
tongue. 

The 31 pairs of spinal nerves are senso-motory, as has be n already 
explained. They also inosculate with the brunches of the sympa- 
thetic ; and are distributed to the several organs of the body nearest 
that part of the spinal column where they have their origin. 

The diseases incident to abnormal and interru ted nervous action 
are classified by the parts specifically affected. Those incident to the 
cerebral lobes are insanity, apoplexy, trance, irregularity of motion 



103 PHYSIOLOGY. 

and headache. Under the head of insanity we have partial insanity, 
including monomania, impulsive insanity, moral insanity and hypo- 
chondriasis ; and general insanity, divided into mania, dementia and. 
anu ntia. 

Spinal disorders include spinal irritation, which gives rise to an 
endless number of morbid conditions. 1. Tetanus or tonic contrac- 
tion of the voluntary muscles, of which we have trismus or lockjaw, 
opisthotonos or contraction of the muscles of the back ; emprosthotonos 
or contraction of the muscles of the neck and abdomen, and pleur- 
osthoonos where the muscles of the body are affected laterally. 2. 
Chorea or irregular action of the voluntary muscles when stimulated 
by the will. 3. Hydrophobic irritation and partial paralysis of the 
pharyngeal muscles. 4. Spasms and convulsions. 5. Hemiplegia or 
paralysis of half the body. 6. Paraplegia or paralysis of either 
side of the body. 

Ct nbro-spinal disorders include affections of both the brain and 
spinal cord. Among those are epilepsy, catalepsy, hysteria, eclampsia. 

Neural disorders include neuralgia, angina, colic, irritable testicle, 
eaffinismuSj irritable womb, — also irritations of the nerves of special 
sense, those of the nerves of motion, and local paralysis from what- 
ever cause. 

The pathological causes of nervous disorders arc enumerated as of 
four kinds; congestive, structural, diastaltic and toxic. 

Congestive derangements arc most common. The skull, for exam- 
ple, can hold only a specific supply of blood and any accumulation 
must necessarily operate abnormally by pressure upon the nervous 
tissue. Accumulations in ihe arteries and veins have the tendency 
to irritate or suspend their functions. Doubtless the brain and spinal 
cord are often affected by congestion, when the fact is not demonstra- 
ble after death. The emotions and passions, pi thora and anemia, 
unaccustomed stimuli, uterine derangement, all produce congestion 
and general disturbance. In coma there is an accumulation of the 
blood in the arteries and arterial capillaries and a corresponding com- 
pression of the veins. In syncope the veins and venous capillaries 



NERVOUS DERANGEMENTS. 103 

are distended. In each case pressure is produced on the brain. 
Syncope differs from coma only in the feebleness of the action of the 
heart. The cause producing loss of consciousness, sensation and 
power of voluntary motion is the same in both. It is sometimes 
hard to distinguish one from the other. 

Partial congestion may occur in one hemisphere of the brain, or 
some part of the spinal cord. Functions may be excited or sus- 
pended; the function of one part of the nervous system may be 
exalted and that of another suspended. In epilepsy the cerebral 
functions are for the time annihilated and the spinal functions 
violently excited. The various phenomena of hysteria and spinal 
irritation are also to be explained in a similar way. We are safe in 
attributing to congestion the most of the functional disorders origi- 
nating in the cerebro-spinal axis. 

Structural derangements of the nervous system are not uncommon. 
Effusion, extravasation, exudation, morbid growths and degenera- 
tions of texture are of this character. Hemorrhage is indicated by 
suddenness of attack; acute exudations by local paiu and fever; 
chronic exudations and tumors by gradual perversion of the mental, 
sensory and motor functions. Intelligence suffers in proportion as 
the disease affects the hemispherical ganglion, or gray nervous matter 
of the cerebrum. 

Reflex or rather diastaltic derangements are the harder to ascertain. 
Traumatic tetanus, the convulsions produced by teething, the gas- 
tric disorders of infants are examples. 

Toxic derangements are numerous and not unfamiliar. Alcohol- 
ism stands at the front. It first excites and then paralyzes the 
mental faculties. So does opium, and so do all the pure narcotics. 
Ether, chloroform, and their associates must be included. Opium 
acts on the cerebral lobes; belladonna on the corpora quadrigemini. 
Tea and coffee excite the cerebral functions. 

Strychnia excites the motor filaments of the spinal cord, producing 
tetanus, etc. Woorara produces just an opposite effect, causing par- 
alysis and flaccidity of the parts. Conium paralyzes the motor and 



104 PHYSIOLOGY. 

sensory spinal nerves, producing paraplegia, beginning at the feet and 
creeping upward The favorite mode of capital punishment 
among the Athenians, in the later years of the republic was, by the 
administration of this drug. 

Hydrocyanic acid produces epileps} r . Cold excites the spinal func- 
tions and stimulates to diastaltic activity, but will finally produce 
drowsiness and stupor. 

Mercury occasions irregular muscular actions. Lead causes 
numbness and palsy, especially in the hands. Stramonium is a 
sedative to the nerves of the bronchi. Aconite, veratrum, digitalis, 
paralyze the action of the heart, and if too long continued produce 
disorganization and coagulation of the blood. 

This description can be continued till it includes pretty much the 
entire Materia Medica. 

The-e subjects are capable of a more extended illustration. The 
purview of the physician properly includes the whole field of 
nature. He is compelled too much to circumscribe his attention to 
phenomena and those of a morbid character. The criminal lawyer 
and peace officer are prone to regard everybody as delinquent. The 
physician is too familiar with them as diseased. He should be 
philosopher and scientist ; whereas he is too often little more than 
an empiric and a mechanic. 

Perhaps on no subject have physicians been move in the dark than 
in regard to the constitution and actual offices of the nervous system. 
They are so fond of reasoning by induction and from the standing- 
point of evolution, that they are voluntarily, if not wilfully, shut up 
against any other conception. It is unwise to hamper the mind in 
so narrow bounds. A man actually animalizes, almost bestializes 
his nature by such a course. Those who deny a soul having exist- 
ence beyond bodily limitations, seem very often to be living illustra- 
tions of their own theories. 

Yet how the impulse of life, growth and development can be sup- 
posed to exist without the operation of some pre-existing law of 
form to direct it, is to us unimaginable. We acknowledge that 



INTELLECTUAL FUNCTIONS. 105 

" exact science" cannot explain it ; but it nevertheless has a being. 
It is none the less a fact because it transcends the scope of human 
conception. 

The mental and intellectual functions of the brain have been men- 
tioned. Reference has also been constantly made to the nervous in- 
fluence or energy, which makes every organ, fibre and other part of 
the body perform its office. But the nature and constitution of this 
peculiar energy has not been duly set forth. It is a potency, as we 
all know. But it is inappreciable by the rules laid down by those who 
treat of science as exact. It has not been weighed, measured, defined, 
or brought within the scope of the physical sciences. It is above all 
these and, therefore, to a great degree, incomprehensible by them. 
Nevertheless it is an entity, a potency, and a fact transcending phe- 
nomena. We must logical. y consider it as an actual substance. It 
is the very material of the life, and produces thos^ phenomena which 
we call vital. However credulous it may appear to declare this, it 
is a more extreme credulity to* disbelieve it. The real entities are 
often those which a materialistic ph losophy is impotent to explain 
and th'. refore eager to deny. 

The accumulation of this substance is attended by vigor, vivacity 
and courage; its exhaustion by fatigue, languor, indifference. It is 
acquired by rest and exhausted by action. A strong will enables the 
production of phenomena which are marvellous, but none the less 
real. The potency denominated faith has changed physical condi- 
tions. The patient who means to recover or who believes that his 
physician has the power to treat him successfully generally recovers. 
Those who yield are pretty sure to die or to convalesce very slowly. 
A severe shock to the mental system is as deadly as to the bodily 
structure. Phthisis prevai's most among populations where there is 
little hope. Hence more women than men die of consumption. The 
same thing may be said of hysteria. It is a fallacy to be guided in 
diagnosis by phenomena. The complaint is nervous, purely because 
the highest bodily organism is nervous. The hysterical patient is 

not so affected because of this organ disarranged or that one abnor- 
5* 



106 PHYSIOLOGY. 

mal, but because the mind craving activity in directions which fill 
up the thought and affection, is turned back upon itself in hopeless- 
ness and disappointment. Both epilepsy and hysteria seem to diffuse 
a contagion. One hysteric patient is likely to have several around. 
An epileptic will be simulated by scores. 

All agencies which deeply impress the mind react upon the nervous 
system. Ecstasy is one form; mesmeric somnambulism is another. 
Catalepsy is a sequence of hyster.ii, religious excitement, or any 
agency that renders the motor nerves inactive. Sleep shows that 
every one has the tendency; dreams, illusions, hallucinations are all 
forms of thought, where external consciousness has been more or less 
silenced. It is idle to attribute so much to the imagination. A mental 
or moral agency has as much reason for being potent on a human 
being or animal as a drug. We understand one just as well as we 
do the other. 

There are many causes in operation at the present time to increase 
sensitive and morbid conditions of the human body. Society is becom- 
ing more and more unsettled. The Anglo-American peoples have been 
characterized by their love of social ties. Home-sickness gnaws the 
very vitals of men. With the financial revolutions in constant action, 
home-life is becoming more and more impossible. The love of family 
and d. anestic life is sapped. More of our populations live unmarried, 
or if married, in relations in which domesticity is abrogated. As a 
result, vitality is impaired. 

"As our civilizttion becomes more complex," says Dr. Folsom, 
" as our capacities for enjoyment intensify, so is the keenness of our 
Buffering sharpened, so do the requisites for moral, mental and physi- 
cal he .1th become more numerous; and, unless a sound education 
gives us a correspondingly greater knowledge of that wonderful 
mechanism, the human body, diseases of all kinds must increase." 

The occurence of epidemics shows great neglect of hygienic and 
sanitary precautions. People who have little interest in living, have 
little public spirit, and arc wilfully as well as voluntarily careless. 
Yellow fever and cholera are natural sequences to such a state of 



CONCLUSION. 107 

things. So are a host of other maladies. If we divert one pestilence 
others become more deadly. If vaccination has abridged small-pox, 
it has intensified and quadrupled mortality from scarlatina, diphtheria 
and consumption. 

Medical men ought to be counsellors to their patrons, rather than 
prescribers for their ailments. They should seek to obviate rather 
than to treat disease. They should be above the temptation of 
practicing on the credulity of patients. The people cannot dispense 
with them ; . their counsel and aid are needed. Disease would be 
shorn of much of its formidablenesss if the wise advice of a physician 
was had in time. It should be the aim, therefore, to render the 
calling, what it should be, a learned profession. 



HYGIENE. 



EXCERPTS 

UPON THE 



PRESERVATION OF HEALTH. 



11 When I ponder on the wealth of human happiness wliich lies folded 
up within this subject, lam tempted to call on the student to leave his 
learning, the philosopher his science, the clergyman his tJieologies, and first 
teach men to obey God's laws in their physical frames, how to glorify him 
in their bodies as an accompaniment, if not a first requisite, to glorifying 
him in their spirits.'" 

Of the importance of the science of health there can be no doubt. 
Everybody wishes to be healthy, and everybody, when they think of 
it, at any rate, wishes to avoid such things as might bring them dis- 
ease and suffering. How to preserve the health is not, however, so 
clear. For the most part men live in ignorance of those laws of 
health by which their actions should be guided; and if we are 
■•ke 1 how we should act under certain conditions, or whether such 
and such a state of things is an unhealthy one, many of us are unable 
to answer the question. One reason of this is the complicated and 
108 



ITS DIFFICUTIES. 109 

changing nature of the requirements. For instance, a man who 
lives under one set of physical circumstances will have to obey one 
set of laws of health; whilst men living under different circum- 
stances will have to observe quite other laws in order to be healthy. 
The Indian, roaming over the prairies, has to look out for altogether 
different dangers from those which surround those who live in 
crowded cities, where, perhaps, one thousand persons, in some dis- 
tricts, live on an acre. That the science of health is really less de- 
veloped and less known than many other sciences lies, then, in the 
fact that it is more complicated than these other sciences, and a 
little reflection will show you why this is so. Thus we see that en- 
ormous effects are produced from very minute causes ; and that this 
is the case not only when we catch a fever, or a particular disease, 
without being really able to tell how we have caught it, or being able 
to assign to it any origin whatever ; but we also find that this often 
holds good when we know that we are introducing a disease, as, for 
example, by the vaccine lymph, which, when introduced into the 
blood, i hough it be but the smallest particle on the point of a needle, 
produces a very extraordinary change on the human body. 

If we look back we find that in the olden time, whenever disease 
and epidemics broke out and spread over the country without ap- 
parent cause, the people attributed these afflictions to the visitation 
of God, or in heathen countries to the work of some offended deity ; 
and even now, iu our times and in civilized countries, we find people 
who ought to know better wearing charms against certain evils, fancy- 
ing that they will keep away disease. The first idea, then, we 
must get rid of in our investigation as to matters of health is this 
notion that disease is brought about by something indefinite and in- 
tangible, something which We must call upon the spirits of darkness 
or the spirits of light to deliver us from. 

We have learned with regard to the epidemics of olden time that 
they were most felt, and the mortality was always the greatest, 
amongst the poor, the dirty and the degraded portion of the popula- 
tion ; as a rule these people suffered more than did those whose 



110 HYGIENE. 

circumstances enabled them to live in a better way. The conclusion 
is therefore that these epidemics are in some way assisted and 
abetted by dirt and degradation, and that improvement in the con- 
dition and habits of life of the people either does avert or lessen the 
virulence of these outbreaks of epidemic disease. This is shown by 
a vast number of facts. In 1869 a most severe outbreak of yellow 
fever occurred in the large city of Buenos Ayres and the Brazils; and 
on investigation it was found that the sanitary arrangements of that 
city were of the lowest and crudest character ; that they had no 
drains, but only enormous cesspools which were never emptied, and 
under their tropical sun became festering masses of pollution and 
impurity. 

In an inquiry as to the cause of production of any disease, we 
may take it for granted that the material causing the disease must 
be brought to the individual either in the water we drink, or in the 
air we breathe, or in the food we eat. I am not speaking now of 
what are termed " hereditary diseases," which are of a totally differ- 
ent character, and do not come into the class of those which can be 
removed by sanitary improvements. Applying this principle to the 
case of cholera, as being one of the best investigated of epidemics, 
we find that the poisonous matter which is the cause of this disease 
is very frequently, at any rate, taken with the water that is drank. 

An instance is that ■ singular case known as the Golden Square 
case. In the course of five or six days, from the 30th of August, 
1854, not less than about five hundred persons died of cholera in a 
district in London, around Golden Square, containing about five 
thousand Inhabitants. Upon investigation it was found that nearly 
all the people who died had been drinking water from a pump in 
Broad street, which was thought to yield very excellent water, but 
was afterwards found to communicate with a cesspool in an adjoin- 
ing house. This case clearly proves that contaminated water may 
produce cholera, 

Take what is known as typhoid or enteric fever. This disease is 
generally supposed to be caused either by drinking impure water, or 



ORGANIC MATTER. Ill 

by breathing foul gases generated in sewers; and it is said that 
twenty thousands die annually from this preventible disease. The 
preveutible nature of this disease is so generally acknowledged that 
when an outbreak of typhoid fever occurs in a hospital the medical 
department direct their attention at once to the coudition of the drains. 

In the first place let us clearly understand that neither the chemist 
nor the physician, nor the microscopist, nor the physiologist, can tell 
us whether the water contains typhoid poison, or whether the water 
contains cholera poison, or whether the water contains the poison of 
any other particular disease. There are no means of ascertaining 
this, even with the most poisonous exhalations from the cholera pa- 
tient except it be the actual test of the action of the poison on a hu- 
man subject. The microscopist cannot detect, for instance, in the 
rice water from a cholera patient that there are any particular germs 
of cholera poison in that offensive liquid, and yet if the smallest 
quantity of it should get into the digestive organs of a man it would pro- 
duce cholera. But, although the chemist is unable to do this, he 
is able to tell the difference between a pure water and a water which 
contains animal impurity ; and if the water contains cholera poison, 
or the germs of typhoid, or of some other disease, or simply animal 
excrementitous matter, it is unfit to drink ; and the chemist can help 
us to detect such matters. 

All animal matter makes a disagreeable smell when it is burnt. 
The difference between burning a feather and burning a piece of 
wood is evident to our senses. Now, this burnt feather smell is 
caused by the presence of a body which the chemists call Nitrogen, 
which exists in the air, but which also enters as a characteristic in- 
gredient into all animal matter. In this respect animal bodies ditfer 
from the bodies of vegetables. Now, when the decomposition of an 
animal body occurs, the nitrogenous portions which are thrown off, 
that is the liquid and the solid products, get into the sewers ; and if 
we find in water a large quantity of this nitrogenous animal matter, 
we may be certain that that water is not fit to drink. (Prof. Roscoe, 
F. R. S.) 



112 HYGIENE. 

Chloride of sodium or salt is another substance found in impure 
■water, which also comes directly from sewage. Exception, of 
course, is made to water already salt or which in its course passes 
salt rock. The analysis of water to ascertain the presence of either 
of the foreign iDgredients is too intricate for description here, and 
must relegate to the laboratory of the chemist. There is one test, 
however, which anyone may employ — which is not so accurate, 
however — and that is by the admixture of a solution of p- rman- 
ganate of potash. This substance dissolved in a little distilled water 
or condensed steam gives a very deep red solution. If a few drops 
are put in a quantity of pure water, a pinkish tinge is given to the 
whole. If, however, it is dropped into water containing organic 
m .tter, in most cases the color will disappear. Sometimes quite a 
large quantity of the solution may be used and complete bleaching 
continued. The explanation is simple ; the potash is rich in oxygen 
and rapidly forms a combination with the organic matter. In doing 
so the color is lost. 

ARE DISEASES PREVENTABLE. 

We have as excellent authority as Dr. Thomas Bond for stating 
that : " On an average, one-half the number of patients treated suffer 
from diseases due primarily to a want of knowledge of the laws of 
health and cleanliness. The ignorance of hygienic laws, which 
affects so disastrously the health of the rich as well as the poor, 
exists in regard to dress, ablution and ventilation. This statement 
may at first appear startling ; but an enumeration of the diseases 
that ean be constantly traced to the above causes will show upon 
how sound a basis the statement rests. The following are ex- 
amples : varicose ulcers, from dress ; skin diseases, from want of 
cleanliness ; chest diseases and fevers, from defective ventilation." 

HYGIENIC LAWS VCTSUS MEDICINE. 

Whatever the uses of medicine— and we are willing to give them 
full credit— these should in no case be neglected. We apprehend, 



DIET. 113 

nevertheless that hygienic treatment, applied thoroughly, would go 
far to remove the necessity of medication. But the idea is Utopian ; 
and almost everybody who professes to despise the art of the physician 
will eagerly resort to it in extremity. In this country we have, 
beside, the notion that we have not the time for slow processes of 
recovery, and so will not enjoy them. Certainly while we may very 
properly speculate about such things in the closet, we must take 
things pretty much as we find them in the active world. But the 
thoughts and ideas which are so frequently stigmatized as impracti- 
cable are generally those w.iich revolutionize in due time. When 
it becomes the interest of physicians to care for the health of their 
patrons, this subject will receive more attention, and medication will 
decline into secondary importance. Heraclitus, the philosopher, pro- 
pounded that caloric, or what some are fond of naming vital elec- 
tricity, being the primordial principle of life should be made its 
perpetual renovator. "Whether this sublime i<lea be realized or not 
there will be achievements like those which were in former ages 
denominated "miracles." (A. Wilder, M. D., F. A. S.) 



Our system requires a certain quantity of carbon and nitrogen to 
kt-.ep up the equilibrium of health. The healthy man requires three 
hundred grains of nitrogen, and forty-six hundred grains of carbon 
daily, to supply the waste that takes place during the twenty-four 
hours. Such being the case, we must select a diet which can supply 
a,< nearly as possible the amount of each of those substances. It 
matters little whether it is vegetable or animal, so that we get what 
is required. Vegetarians live for the most part on vegetables ; and 
there is no doubt that a well selected vegetable diet is capable of 
producing in the greater number of individuals the highest physical 
development of which they are capable. It would, however, I 
imagine, be d fficult for the major"ty of working men to get such a 
diet of vegetables as is necessary all the year round, so, as a general 



114 HYGIENE. 

rule, most of us have a mixed diet, that is, partly vegetable and 
partly animal, A good proportion is to have one of animal to four 
of vegetable. I fear very much that a great many men, and women 
too, of all classes, eat a great deal more of animal food, in the shape 
of meat, than they have any need to do or is good for them. I have 
known families among the working cesses, having meat three times 
a clay, living in fact mostly upon meat. 

Let us endeavor to estimate the value of meat as an article of diet. 
One thousand grains of it contains one hundred grains of carbon, 
and three hundred of nitrogen. Therefore to obtnin the forty-six 
hundre 1 grains of carbon which the system requires, no less than six 
and one half pounds of meat must be consumed daily, whilst the re- 
quisite three hundred grains of nitrogen are contained in one and 
one half pounds of meat ; consequently three or four times more 
meat must be consumed to supply the carbon th.-.n is necessary to 
furnish the nitrogen. You will at once understand, then, that a diet 
composed only of meat is a very bad one ; because if we eat enough 
to get the necessary amount of carbon, we have far tco much nitro- 
gen, and it we eat just enough to supply the nitrogen, v>e have too 
little ca'bon. 

As a contrast, let us examine the value of bread as a food. One 
thousand grains contain three hundred grains of carbon and ten of 
nitrogen ; hence to obtain the three hundred grains of nitrogen re- 
quired by the system, thirty thousand grains <r moie than four 
pounds of bread must be consumed; but to obtain the requisite sup- 
ply of nitrogen a quantity of bread must be consumed containing 
exactly double the quantity of carbon required. 

From these facts you may see the value and economy of a mixed 
diet, since by calculation we find that two pounds of bread and 
three-quarters of a pound of meat are sufficient to compensate the 
daily loss of the system in a healthy man. 

Average beef or mutton is calculated to contain fifteen per cent, of 
carbonaceous and twenty percent, of nitrogenous material. Pota- 
toes have twenty-four per cent, carbonuceous and two of nitrogenous, 



FLESH AS FOOD. 115 

or twelve of carbon and one of nitrogen, or very nearly the propor- 
tion of fifteen to one, which we found the system required. 

Oatmeal has sixty-six per cent, of carbonaceous and sixteen of 
nitrogenous material ; hence it has nearly as much nitrogenous matter 
as beef , and four times as much carbonaceous, and so is a much better 
article of food lhan beef, taken alone, as regards the requirements of 
the system. Skimmed milk contains about an equal quantity of 
carbonaceous and nitrogenous material. 

Now beef may be said t > be the common diet of England, as oat- 
meal is of Scotland, and potatoes are of- Ireland. If three men were 
selected and fed, the first on beef, the second on oatmeal, and the 
third on potatoes, it would be found that he who had beef alone 
would not thrive as well as either of the other two. 

However, bringing these considerations to our assistance in pelecting 
a diet which will supply to the hardest working man all he wants, 
in a plain and inexpensive form, I would observe that, taking the 
Scotchman's fare with good milk and bread as breakfast and supper, 
and the Englishman's and Irishman's fare united to form dinner, give 
a diet, which both theoretically and practically, is about the best 
that can be devised. (John Haddom, M. D.) 

MEAT. 

No nation, not Cannibal or Esquimaux, has ever been such a meat- 
eating people as the Americans. But, wilh beef, our great staple 
meat, at 13 or 14 cents a pound on the hoof, and at from 20 to 30 
cents at wholesale, and from 25 to 35 cents a pound at retail, it is 
quite plain that the common people — the well-to-do, even — cannot 
afford to indulge very freely in beef ; and, as all other kinds of meat 
are proportionately high, and as even fish is very dear, it becomes a 
serious and difficult question for people in moderate circumstances 
to answer : What shall we eat ? How shall we live ? "We don't 
know why meat should be so dear. The excuse has been that gold 
was so high. But with gold at oar, meats are as high as they were 
when gold was at 130, or even higher. 



116 IIYGILNE. 

Economy in cooking and serving mea's must be tried. Many 
families waste half as much as they eat, by their slovenly way of 
cooking, and dishing, and using meats. Strong, nourishing 
praps may be more freely used — or rather stews of meat and 
vegetables, against which many people have an absurd preju- 
dice, as neither nice nor genteel. Properly mad*' they are extremely 
nice, besides being nutritious and economical ; and as for the gen- 
tility of the thing, that is all in the eye — all nonsense. 

But then cur people must learn to depend less on meat , and to 
eat farinacous and vegetable food and fruit more freely. It is a 
mistaken notion that men cannot work without being glutted with 
meat. During half the year at least our laboring men would be 
better able to work and to endure, on food largely composed of 
wheat, and rye, and oats, and rice, and vegetables, and fruit, than 
on a diet mainly of meat ; and all the year round it would, no 
doubt, be good for them and all others, to eat less meat— much less 
than is now common among us. (Traveler.) 

MEAT FOR BRAIN-WORKERS. 

Dr. H. P. Fowler, in concluding a learned and valuable essay on 
this subject, remarks: " When a man is stricken by paralysis (one of 
the most formidable of brain diseases), what does the wise physician 
say ? ' You must eat no meat; it is altogether too exciting to the 
brain.' It is the best and sometimes almost the only thing that can 
be done for the sick man now; but ii is like locking the barn-door 
after the horse is stolen,' for very rarely, if ever, does he regain his 
former health and vigor. There are hundreds of men this moment 
in New York — clergymen, active business men, lawyers authors, 
students— all brain-workers, who are living high-pressure lives and 
eating meat two, and perhaps sometimes three times a day, and who, 
on account <>f this marriage of excitants, are doomed, sooner or later, 
to he laid upon the shelf, either from paralysis or general break down 
of the nervous system, or some mental or nervous disease. If they 



MEAT. 117 

were coal-heavers, truckmen, omnibus drivers, etc. etc., I do not 
think they would be in any danger, for I am not a vegetarian. 

" Those who perform manual labor or those who do not work at 
all, either with hand or brain, provided they do not lead very inactive 
lives, or do not possess a very sensitive nervous organization, can eat 
meat during cool or cold weather with impunity. Although the 
cases are very few in which its consumption is a sine qua non to the 
maintenance of perfect health and strength, still, as it is a very en- 
joyable article of diet and we are all likely to gratify our palates, it 
may safely be eaten by many people. Individual cases prove but 
little ; still, I will state that I knew of a professor in a medical col- 
lege, a surgeon, who was obliged to relinquish the use of meat because 
it made him too nervous to perform surgical operations before the 
students. It has an equally marked, although dissimilar effect upon 
myself, producing snch distressing insomnia (sleeplessness), that I 
have not eaten meat, of any consequence, for years. My experience 
and observations show that in many cases of insomnia, not depend- 
ent on other diseases, there is so strong a probability that meat is 
causing all the mischief, that its relinquishment should be insisted 
upon by the attending physician before resorting to sedative or nar- 
cotic drugs. 

" So greatly conducive to irritability of the nervous system is 
meat, especially beef, that among its minor evils may be reckoned 
the weeping over lessons, the fractiousness, the petulence, the hyster- 
ical laughing and crying, the low spirits, excessive home-sickness, 
etc., etc., which appear to be the usual accompaniments of boarding 
school life. This is lamentable. Whenever I see a school of young 
ladies afflicted with ' nervousness,' it reminds me of a beautiful 
garden of roses infested with mosquitoes. It always requires consid- 
erable moral courage on the part of the medical attendant to prohibit 
the free use of meat, except in cases of very grave nervous disease, 
like paralysis etc.; for it seems to be the universal opinion, that the 
butcher's cart and meat market are the only barriers between 



118 HYGIENE. 

mankind and death. This is not so — provided food equally nutri- 
tious is substituted for it." 

fish. 
The idea of some physiological speculators that fish is specially a 
brain food is not sustained by the intellectual character of the people 
who live mostly on a fish diet. It is almost an adage both in and out 
of the medical profession that this has a remarkable effect upon the 
brain and that it is the greatest of brain foods. A short sojourn 
among fisherman would dispel any such delusion. There is not the 
slightest difference in intellectuality between one who eats much fish 
and one who eats little or none, that can be traced to the diet alone. 
Besides eating fish at every meal would soon cause dyspepsia. The 
best food for brain workers is fruits, wheat, oatmeal and as a stimu- 
lant muton and beefsteak. 



It is hardly necessary to say that eggs are an excellent form of nour- 
ishment, if rightly used. They contain, like milk, just those sub- 
stances needful for the body, only more concentrated. They are 
rich in both fat and albumen. 

If an vgg weighs two ounces it will contain about 200 grains of 
solid substance, as each ounce r( pn sents about 100 grains of solid 
matt r. In choosing vgg*, do not fail to get fresh ones, which are 
transparent on looking through them toward the light. Bad eggs 
will tioat in pure water. Good eggs sink in water in which ten parts 
by weight of salt has been dissolved. 

Aside from the water, of which eggs contain less than meat, the 
f« rm« r is almost pure nutriment An egg is more nutritious than 
meat. There is no waste in the form of bone, rind and tough pieces. 
A wealthy friend once told me that for his small family it took about 
tli ice pounds of meat per day for each person ; but this was because 
there was so much waste in flesh. Flesh is the most expensive of 
food-. Egga arc tne cheapest animal food there is. There is nothing 
artistic about meat, but good eggs are clean, and look beautiful when 



WHEAT. 119 

properly prepared. After eiting them the plate is not covered with 
waste pieces, fit only for dogs and cats. I think eggs, considering 
the nutriment lhey contain compared with beef, at least four times 
cheaper. They are more tasily cooked. To roast or broil a pound 
of beef requires considerable fuel and lakes much time. To cook a 
pound of eggs little of either. The English vegetarians eat no flesh. 
They are generally long-lived, much longer than other people average. 
They use eggs moderately. 

The way to cook an egg, according to our notion, is to put it into 
water of a temperature of 180 degrees and let it cook fifteen min- 
utes. The inside or yolk will then be hard, and the white of the 
eg^ will not be hard, but flocculent like curd, and easy of digestion. 
A little skill will teach any one how to cook eggs thus, and they will 
be delicious. The only dressing admissible on an egg is a little good 
butter. Pepper and salt are only demanded. by a morbid taste. 
Hard-boiled eggs, I think, are worse than nothing. A fresh egg 
dropped in water about 180 degrees Fahr., and allowed to remain 
some fifteen minutes, soas to cook through, and then laid on a nice 
piece of brown bread, which has been toasted and dipped in hot 
water, is good enough for a king. 

Custards made from egg* are both nutritious and wholesome. For 
the feeble they are better than beefsteak, and may be used freely. 
(Herald of Health.) 

As the custom prevails among the majority of English speaking 
people of using refined whe«t flour, some nitrogenized body must be 
introduced into the system to meet its demands. Hence the use of 
mf j at, eggs, choese, etc., is a necessity unless the vegetarian plan is 
adopted and the whole grains or unbolted flour is utilized. 

WHEAT. 

"Bread is the staff of life." Like many trite sayings it is likely 
to cover a fallacy. We know little of the history of this ex- 
pression, but are inclined to think it must have had its origin in times 
anterior to the manufacture and sale of triple extra refined flour. 



120 HYGIENE. 

If in the context irJwnt is substituted for bread, we indisputably 
accept the proposition and its application. No staff can furnish 
proper support to life that relieves but one organ or part of the 
body, to the exclusion of others. The very b< st (?) flour supplies 
material fat and heat only, consisting almost entirely of starch. 
The gluten or flesh-forming elemei.t is on the surface of the grain, 
and is almost entirely lost in separating the bran. Used alone it is 
a poor support, but not quite as insufficient as some other single 
element, for instance albumen, which exists in the white of an egg, 
and which it has been experimentally discovered will produce star- 
vation ; the animal's disgust for such food being so great, that even 
if it is swallowed it is not digested. Besides "the excess of farin- 
aceous matters, especially when combined with a deficiency of 
the albuminous, (as it too frequently is among those who are 
obliged by necessity to live chiefly upon a ' poor' vegetable diet) 
tends to the production of the rheumatic diathesis," or condition of 
the system tending and liable to rheumatism, " which seems to con- 
sist in the mal-assimilation and wrong metamorphosis of the com- 
ponents of the tissues, especially favored by the presence of lactic 
acid or of some other product of the metamorphosis of the sach- 
arine compounds." 

But what have we in the flour to supply nourishment to and repair 
waste of the brain and nerve tissues ? Simply nothing ; the phos- 
phates are entirely wanting. But the whole grain, and the rule will 
app'y to most of other grains, tak- n in its entirety gives us about all 
the elements required. Natue has ministered to man's wants in her 
usual perfect manner, combining in this small compass, the heat- 
producing, flesh-making, and brain and bone forming elements. 
Thia is quite sufficient to support life. 

We must however deal with the facts as we find them. The ereat 
majority of Eng'ish speaking people wi'l continue to use refined 
flour in making bread. Hence flesh, foul, fish, eggs, cheese, milk 
and the like are necessary. Most nitrogenized food should be taken 
at the morning or noon meal, certainly not subsequent to three p. m. 



WHEAT. 121 

The quantity will depend much upon the occupation and habits of 
the individual. The training athlete will eat and digest three 
pounds of beef per diem ; the milliner has a sufficiency in one tenth 
as much. 

The question of how to live cheaply has lately been agitated to 
considerable extent. Looking at the subject from the physiological 
standpoint of meeting all the requirements, we know of no cheaper 
food than whole grain wheat. This can be purchased, at most flour 
mills by weight or by the bushel. An half cupful soaked over 
night in cold water and boiled one hour is hearty and palatable. A 
great improvement both in cooking and in the variety of uses to 
which it is applicable, is made by grinding in a hand mill, course or 
fine, when wanted. These handmills for family purposes can be 
had in most cities. 

It will be observed in the foregoing paragraphs that I have spoken 
of the need of meats or flesh to the bread eater. The strong lan- 
guage in which I have advocated the use of grain may not be suffi- 
cient to show my convictions upon the subject of flesh eating, and 
which I wisli the reader to believe and adopt. My sentiments are so 
cleverly stated in an essay by A. H. Sexton, F. C. S., that I cannot 
refrain from using his exact language. 

1. Man is constituted for a vegetable diet. In structure he resem- 
bles herbivora (grain-eating animals) much more closely than the 
carnivora (flesh-eating animals.) His teeth are exactly similar to 
those of the apes, suggestive of the diet of fruit and grain. The 
biblical account of man's creation indicates the true source of his 
diet. The evidence of tradition confirms this. The poets of every 
age, from Ovid to Shelley, have testified in its favor. 

2. All the material necessary for the sustenance of the human body 
is supplied by the vegetable in one available shape. All nutriment 
is derivable directly or indirectly from the plant. Liebig affirms this 
strongly. The chemical analysis of foods is conclusive on this point. 
Adam Smith, in his "Wealth of Nations." while doubting if butchers' 
meat were any where a necessity of life, affirms the truth, so well 

6 



122 HYGIENE. 

known from experience, that Nature, without flesh of animals, affords 
the most plentiful, the most wholesome, the most nourishing and 
the most invigorating diet. "Good wheaten bread," says Dr. Car- 
penter, "contains more meat than any other substance in ordinary use, 
and contains the proportion of azotized and non-azotized matter 
which is adapted to supply the wants of combustible material under 
the ordinary conditions of civilized life in temperate climates. 
Health and strength can be more perfectly maintain- d upon this sub- 
stance than on any other taken alone. " Figs are as nutritious as bread. 
Peas and beans contain one-third more nitrogen than meats. 

3. A vegetable diet is capable of maintaining vigor, bodily and 
mental, and is favorable to longevity. Observe the superior strength 
of herbiverous animals. Who can fail to recognize in the history of 
nations abundant evidence in proof of this position ? The Scotch 
and their oatmeal have become proverbial ; while every one has heard 
Dr. Johnsons's definition of oats as food for men in Scotland and 
horses in England — "and such men and such horses /" The native 
Irish are quite as good instances. The ancient Greeks, the victors of 
Marathon — the Roman army at the time of its greatest powers — the 
famous Greek athletes — all fed oh vegetable diet. So the Japan- 
ese and many of the natives of Hindostan of the present day. An 
Indian messenger has carried dispatches from Calcutta to Bombay in 
twe nty-five days, traveling at the rate of sixty-two miles a day. In- 
habitants jof the Himalaya fed only on rice are superior in strength to 
our own seamen. Sir William Fairbairn described the boatmen and 
water-carriers of Constantinople as physically "the first men in 
Europe,"— though all water-drinkers— their diet being chiefly bread, 
cucumbers, dates, etc. The porters of Canton living chiefly on rice 
and fruit carry enormous weights. A large portion of the inhabitants 
of the world never touch meat. The Peruvian army led by Gen. 
V;ildcz in 1823, marched from Lima to Arequipa, a distance of 750 
miles, in eleven days and then routed a large army, on a diet of 
parched corn. Dr. Guy, in reporting on prison dietaries, gave his 
opinion unhesitatingly "in favor of the sufficiency of a dietary, from- 



WHEAT. 123 

which the meat element is wholly excluded," as likely at once tc pre- 
seive health and with it the capacity for labor. It is well known 
that the Harvard boat-crew trained on vegetable diet. Dr. Carpenter 
(while advocating a mixed diet) concedes that a well selected vegeta- 
ble diet is "capable of producing the highest physical development." 
Lord Heathfield, who defended Gibraltar, neither ate animal food nor 
drank wine. 

4. A vegetable diet conduces to a higher moral state ; while car- 
niverous animals are ferocious, the herbivera are docile. Races which 
eat flesh largely are most savage, i. e., the Tartars and North Ameri- 
can Indians. It was the observation of Bishop Heber that cattle fed 
on fish became unmanageable. Porphyry of Tyre, writing about 
the middle of the third century, in choice and forcible language de- 
nounced indulgence in appetite which excites the passions and lead 
men to " ruin their health and to renounce the joy of an upright 
conscience." 

5. The vegetable diet is most economical and would largely increase; 
the producing powers of the country. The importance of this be- 
comes evident when we look at the food which we relatively produce 
and import. An acre of land will produce — mutton, 328 lbs. per 
year; beef, 1,821 lbs. ; wheat, 15,261 lbs ; potatoes, 22,400 lbs. The 
land could support an hundred times as many people on a vegetable 
as it can on a purely flesh diet. As population increases this fact 
will command attention. The culture of fruit is much more eco- 
nomical tlinn cattle-breeding. From 3,000 lbs. to 15,000 lbs. of 
strawberries can be produced per acre. 

6. A vegetable diet conduces to health ; a meat diet predisposes 
to disease. The entozoa and internal parasites of men are derived 
from the lower animals. Almost all meat is diseased, especially if 
iatted. Lean meat would not sell. Stall-feeding naturally gives 
rise to lung and other diseases. Ought we to wonder at the increase 
of consumption in the human subject ? Gout, and similar diseases, 
are naturally produced by high and intemperate living. Excretion 



124 HYGIENE. 

and decay are constantly going on in animals. A percentage of all 
flesh meat is decayed and ready to be excreted. 

7. Humanity to the animal creation is incompatible with " sport" or 
with the needless slaughter of animals for food. Dr. Hawkes worth 
chases " among the dreadful and disgusting images which cus- 
tom has rendered familiar," are those which arise from eating animal 
food. " He who has ever turned with abhorrence from the skeleton 
of a beast which has been picked by birds or vermin, must confess 
that habit alone could have enabled him to endure the sight of the 
mangled bones of flesh of a dead carcass which every day cover his 
table; and he who reflects on the number of lives that have been 
sacrificed to sustain his own, should enquire by what the account 
has been balanced and whether his own life has become proportion- 
ably of greater value by the exercise of virtue and piety, by the superi- 
or happiness which he has communicated to reasonable beings, and 
by the glory which his intellect has ascribed to God." No man has 
a right to set another to do for him that which he would not do for 
himself. Who can endure to see the agonies of a dying lamb to 
satisfy his own appetite ? 

It is objected that a flesh diet is more savory — that it has acquired 
its strength of habit and that undeveloped appetites need stimulating 
food. Flesh food is stimulating, and the organism makes a violent 
attempt to rid itself of stimulating substances. All stimulants are 
abnormal and injurious and produce depression. Hence the craving 
for stimulants; and hence the habit of flesh-eating naturally leads to 
drunkenness. All stimulants tend to shorten life. Animals may be 
made to minister to our use without slaughter ! 

"With but little effort, particularly if attempted in the summer 
time, any one may easily change from a mixed diet, or one princi- 
pally of flesh, to an exclusively vegetable diet. With most persons 
the change should be gradual. During the summer we should eat 
the lighter foods such as fruits, vegetables, wheat, rice. etc. ; during 
the winter, tin- heat producing such as oats, beans, nuts, corn meal, 
dried peas, etc. 



FRUIT. 125 

We, as a nation, make our bread from this impalpable dust of 
wheat, thrice bolted, boltgd to death. The life having been crushed 
out, the best part of the food must be sifted out or we will not touch 
it. We carefully reject the portions of the grain from which the 
enamel of our teeth is made, and expect nature to make bricks with- 
out straw. But she does not ; and our wretched teeth, friable and 
chalky, must be dug out before. we reach middle age and replaced 
with celluloid. No where else do men live so exclusively upon 
flour from which silicious particles have been expelled ; and, as a 
consequence, foreigners wonder at our army of demists — one or two 
in every hamlet — relieving the aches that arise from our " double 
extra superfine," and filling our offended mouths with gold and pot- 
tery ware. The horses eat our enamel, and from want of the me- 
chanical aid offered by innutritious food, our own digestion suffers. 



We hardly know how to account for the popular impression that 
still prevails in rural districts, that the free use of fruits is unfriendly 
to health. It has much to do with the scarcity of fruit gardens and 
orchards in the country. As a matter of fact, cities and villages are 
much better supplied with fruit the year round, than the surrounding 
countiy. There are hundreds of farms, even in the oldest parts of 
the land, where rhere is no orchard and the only fruit is gathered 
from a few seedling apple trees grown in the fence-corners. The 
wants of the cities are supplied not so much from the proper farm- 
ing districts, as from a few men in their suburbs, who make a busi- 
ness of growing fruit for market. The farmers who rai<e a good 
variety of small fruits for the supply of their own families, are still 
the exception. The villager, with his quarter or half-acre lot, will 
have his patch of strawberries, his row of currants and raspberries, 
his grape-vines and pear-trees, and talk intelligently of the varieties 
of these fruits. His table is well supplied with these luxuries for at 
least half of the year. But there is a lamentable dearth of good 



126 HYGIENE. 

frnits upon the farm from the want of conviction that it pays. It 
does pa\' in personal comfort and health if in nothing else. 

The medical faculty will bear testimony to the good influence of 
ripe fruit upon the animal economy. It regulates the system better 
than anything else, and fore tails many of the diseases to which we 
are liable in the summer and fall. A quaint old gentleman of our 
acquaintance often remarks that apples are the only pills he takes. 
He takes these every day in the year, when they can be found in the 
market, and tills up the interval between the o'.d and new ciop with 
other fruits. He has hardly seen a sick day in forty years, and pays 
no doctor's bill. We want more good fruit, especially upon our 
farms, and the habit of eating fruit at our meals. This is just One 
of the matters in which farmers' wives can exert an influence. A 
few dollars invested now will bring abundant returns in from one to 
five years. It is more intimately connected with good morals than 
our philosophers think. With good digestion it is quite easy to 
fulfil the law of love. (American Agriculturist.) 

Many who surfer from the use of the strong acid frnits, such as 
sour apples, currents, cranberries and the like, may often eat the 
sweet with impunity, such as dates, figs, berrks and grapes and 
sometimes the others, if they are cooked. 

now TO EAT. 

Eat at regular intervals. Two meals are not enough if laboriously 
employed. Three has disadvantages to those sedentarily inclined : 
these over-cat and do excessive mental work before digestion is fairly 
begun. Some have introduced a maxim, always get up from the 
table hungry, or its equivalent, always leave the last slice of bread 
desired. The results of careful inquiry and study leave it without 
foundation. If you will eat slowly, and masticate well and drink 
little »>r not at all at your meals, you can hardly rat too much. Hun- 
ger is a demand of the blood for nourishment, communicated through 
the n< irons system. Hastily filling the stomach to repletion termin- 
ates too quickly for any appreciable digestion or absorption. The stom- 



FOOD FOR INVALIDS. 127 

achis overloaded, therefore, before the response can be given that a 
sufficiency is recti ved. By the plan above indicated, this waste of 
food, this loss of comfort and the ill-nature and dyspepsia which 
sooner or later follow, are all avoided. Enough is better than a feast, 
and if you have not learned to subdue your passions, some practice 
and the exercise of the judgment will at first be required. 

FOOD FOR INVALIDS. 

No exact rule can be laid down respecting the proper regimen for 
the sick. Much depends upon the nature of the disease, and much 
also upon the former habits. If the disease is characterized by ex- 
tensive, or a high grade of, inflammation, fluid foods do better. 
There are times in which only water is indicated, for instance, when 
w r e find loss oi appetite and a heavily coated tongue. Milk is one of 
our best articles, and it may be varied with gruels, Graham flour, or 
oatmeal, and occasionally with soft custard. When the appetite is 
wanting, little or no food is needed. If administered, it will either 
aggravate the disease or pass from the body undigested. Besides, 
the food is not relished as the taste is impaired by the coating upon 
the tongue, unless h'ghly spiced, and this of itself may be hurtful. 
Persons usually need water, and, if frequently given, they will not 
only never complain of thirst, but will also more speeddy regain the 
appetite for food. 

Those suffering from chronic diseases require quite different advice. 
In many instances although much food is swallowed, the body is 
slowly starved from the lack of digestion and assimilation ; indeed 
good food is destroyed in great quantities by fermentation. One point 
is certain : the food must be plain nutritious, unstimulating, and in 
quantities limited to the amount of digestion. This can easily be 
discovered hy the presence of a keen appetite before the regular meal 
time, the returning relish during the meal and the absence of dis- 
comfort following. 

BEEF TEA. 

Beef tea is a stimulant in the same sense that alcohol, tea, 



123 HYGIENE. 

coffee and chocolate are stimulants; but they possess scarcely a par- 
ticle of real nutritive value. 

It is a common practice with many persons, even with physicians, 
to recommend beef tea for feeble patients who arc supposed to need 
concentrated nutriment. Because a pound of extract of beef is made 
from thirty pounds of beef, it is thought to contain in a condensed 
form the nuirient elements of the whole thirty pounds of meat. In- 
stead of this, it contains scarcely a particle of the nutrient elements, 
but nearly all of the stimulant element of the flesh. 

Liebig, the inventor of beef extract, distinctly states in his de- 
scription of it that it is not a food, but a stimulant, and as such, he 
classed it with tea and coffee. 

In view of the e facts, it is indeed surprising that an article of so 
little food value should still be recommended by many physicians as 
the best of all aliments f « r those who need nourishing food. (Health 
Reformer.) 

LEAD-POISONING BY COOKING UTENSTLS. 

At a meeting of the Michigan Board of Health this subject received 
attention. The Health Reformer published the following abstract: 

Dr. Kedzie presented some results of his investigation on the sub- 
ject of leal-poisoning by means of tinned ware and other vessels 
containing lead. lie siid it is well known that there are substances 
actively poisonous when taken in large doses, that when taken in 
small but repeated doses often produce effects so obscure that they 
may be mistaken for the symptoms of some chronic disease. 

Lead, arsenic, antimony and copper are examples. The chronic 
poisoning which may be caused by minute d ses of any of these 
metals, and the possibility of mistaking such metallic poisoning for 
some disease of B different nature, should warn us against their use, 
OT make us careful and guarded while using them. Vessels in daily 
use for preparation or serving of food are especially liable to affect 
the physical condition if they contain any material which will insidi- 
ously sap the foundations of health and strength. Culinary vessels 



LEAD POISONING. 129 

which are cheap, durable and convenient and without injurious influ- 
ences on the health bear au important relation to the comfort and 
well-being of the people. Of all cheap metals for such use, tin fulfils 
these conditions better than any other. It is comparatively cheap, 
resists oxidation by exposure to air and water, has a white color, 
is not readily dissolved, except by strong mineral acids, and the 
*only salt of tin which is actively poisonous is the chloride, which will 
never be formed in the domestic use of tin vessels. The readiness 
with which iron surfaces may be coated over with it contributes to its 
valuable uses. 

Unfortunately, while tin is comparatively cheap and safe, lead is 
cheaper and very dangerous. Yet the two metals readily unite, 
forming an alloy which may be used in place of tin, but which will 
generally oxidize and be dissolved by acids more readily than either 
metal of which it is composed. The danger of poisoning by the use 
of such vessels is very great. The attention of the State Board of 
Health has been called to this subject by a letter from Dr. Dorsch, 
who writes that he has seen cases of paralysis agitans which had been 
taken for chorea, although other symptoms of lead-poisoning were 
present, and investigation showed in all cases that cooking and eat- 
ing with tin spoons or in earthen and iron vessels with a coat of lead 
were the cause. The same is true with milk vessels. The acid dis- 
solves the lead salts and children are poisoned, dying by tubercles of 
the brain, meningitis, fits and paralytic affections. 

Grown persons do not escape, although resisting longer. A similar 
danger arises from tea and coffee pots of earthen ware or composition 
metal, from tin sieves and tunnels, and almost all cooking utensils 
used by the poor. They are about as dangerous as the adulteration 
of food and spices, so common all over the country. 

The danger of lead poisoning is a matter of great importance, 
because so large a proportion of our population employ tinned vessels 
for culinary and table use. The alloy of tin and lead oxidizes much 
more readily than pure tin and the oxide of lead is very soluble in 
acetic acid or vinegar, or lactic acid, forming sugar of lead. It also 
6* 



130 HYGIENE. 

form? salts with malic and citric acids, which are contained in apples, 
cherries, gooseberries, currants, or any other acid fruits. When 
cooked in vessels containing lead, or even placed in them for some 
time, they are liable to take it up and become very injurious thereby, 
because all salts of lead are poisonous. In th's way a large portion 
of our daily food may be a vehicle of poison if prepared or contained 
in vessels containing a sensible amount; and this danger is greater 
because the compounds of lead are cumulative in their influences. * 
A person may not be poisoned by one or two small doses, but minute 
doses taken for a long time will break down the heals h and even de- 
stroy life. 

The doctor said that of a large number of specimens of tin plate, 
tinned iron, and other culinary articles examined by him, he found 
in almost every instance an alloy with lead, and it was often present 
in large quantises. It is au astonishing fact that a large proportion 
of the tinned wares in the market are unfit for use because of the 
large quantity of lead with which the tin is alloyed. 

TEST FOR LEAD. 

Place a drop of strong nitric acid on the tinned surface and rub it 
over a space as large as a dime. Warm it very gently till dry, and 
then drop two drops of a solution of iodide of potassium on this 
spot. The bright yellow iodide of lead will form on the spot if the 
tin contains lead. This test can be rapidly applied, and the results 
are decisive. The doctor was inform -d that a peculiar kind of tin 
plate, the tinning composed mostly if not entirely of lead, was coming 
into general use for roofing cave-troughs and water-pipes. The lead 
thus exposed would be in conditions favorable for oxidation, and a 
quantity of oxide and carbonate of lead would be washed away in 
the Kin-water and deposited in the cistern with every storm. Sus- 
ceptible persons may be poisoned by washing in such lead-charged 
water, and all persons drinking it even after it has been filtered, will 
be in danger of chronic lead poisoning. Earthen vessels are usually 
glazed to overcome their poro.-ity. In many cases this glazing con- 



LEAD POISONING. 131 

sists of fusible silicates of the alkalies and alkaline earths. These 
have no injurious influence on the health. Oxide of lead, when 
added to the alkaline silicates, borates, etc., makes a very fusible and 
closely adhering glazing, and is sometimes used ; but its use is very 
dangerous, especially if the vessel contains acid substances. The 
glazing decomposes, lead salts from it are either dissolved or are me- 
chanically suspended in the contents of the jar, and there is great 
danger of chronic lead poisoning. This danger is, unfortunately, 
very common. 

"Within a short time an enamel has been successfully applied to 
vessels made of iron plate, the enamel or glazing taking the place of. 
tin-coating or tin-plate. As these vessels are coming into general use 
it is a matter of public interest to know what would be iheir influence 
on public health. A culinary vessel, to be safe, must be imperme- 
able by water and grease. Metals, especially where vessels are made 
without seams or joints, such as pressed tin-ware, glass, and many 
kinds of porcelain, are admirable in this respect. If the new enamel- 
ed ware shall prove satisfactory, it will be an important acquisi- 
tion. At the present time the most hopeful outlook for good, safe 
and cheap culinary vessels lies in the direction of some fixed un ab- 
sorbent enamel for pressed iron ware which will maintain an un- 
broken surface, under all conditions, for domestic use. 

Another indispensable condition for a safe culinary vessel is that 
it shall not contain any poisonous material by which the food cooked 
or contained in it shall be injuriously affected. 

The specimens of granite ware which he had examined failed to 
reveal any poisonous or injurious substance. He regarded it as a 
safe material to use, but feared its power to resist the tendency to 
crack after it had been frequently heated. The marbleized iron ware 
presented very different results. The enamel was found to contain 
a large amount of lead, and even traces of arsenic were obtained 
from the enamel by the use of Marsh's apparatus. 

In a quart basin of this marbleized iron ware he placed eight 
ounces of water containing five per cent, of nitric acid, heated it 



132 HYGIENE. 

boiling hot, and kept the whole in a warm place twenty-four hours, 
then evaporated the dilute acid to dryness, dissolved the residue in 
water, filtered, and from the filtrate precipitated the lead, obtainiug 
in this way what was equivalent to twenty-three grains of lead. In 
a similar basin of marbleized iron ware eight ounces of vinegar (free 
from lead) were placed and kept in a warm place twenty -f our hours, 
and then treated in the same manner as the dilute acid. This re- 
sulted in obtaining what was equivalent to seven grains of lead. On 
powdering some of the enamel and heating it with concentrated 
acids, very distinct traces of arsenic were obtained. This was prob- 
ably not present by design, but accidentally from being contained in 
some of the substances used in making the enamel. A culinary ves- 
sel which contains so much lead and in such a state of feeble combi- 
nation that eight ounces of ordinary cider-vinegar can, in twenty- 
four hours, dissolve from a quart basin what is equivalent to seven 
grains of metallic lead, must be a very unsafe vessel for general use. 

ARSENICAL WALLS. 

The covering of our walls is a matter closely connected with 
the sanitary , condition of our dwellings, which has hitherto been 
unaccountably neglected both by the occupants and by health 
officers. With paper, paint and distemper wash, containing the 
dea-Uy and volatile poison of arsenic, which is continually given off 
in the form of an impalpable dust; and also of arseniuretted hydro- 
gen which is gaseous at the common temperature of the air, can we 
wonder at deterioration of health and races ? The fact that nearly 
all the green coloring now in use is arsenical has be< n indisputably 
proved by analysts. Specimens can be produced of papers con- 
taining from six to fourteen giains of arsenic to the square foot, and 
papera containing only a figure or line in green are arsenical and 
dangerous. Yel such papers are seen everywhere, in the houses of 
the rich and poor, in ciiy and country. Medical men have these 
papers on their walls and suffer unawares. Nor is the 
arsenic confined to the green coloring, but is used in papers of all 



WATER 133 

colors, even in white, for its gloss and finish. It often happens that 
dangerous arsenical papers are concealed underneath harmless ones, 
owing to the pernicious custom of putting one paper over another. 
Wherein lies the remedy ? The Prussian Government, in 1860, 
" forbid the use of arsenic in any colors, whether distemper or oil, 
for indoor work," yet in this country arsenical paint is freely used on 
the walls of our rooms and on Venetian blinds (the green paint con- 
taining 75 per cent, arsenic). Of what use, comparatively speaking, 
are restrictions on the sale of arsenic by druggists, when painters 
and paper-makers purchase and use it in unlimited quantities, even 
by tons, wc ekly, thus poisoning the people by wholesale ? Protec- 
tive legislation is urgently demanded. All papers now in use that 
do not stand the test should be removed, and the walls colored with 
whiting and size, tinted with safe colors, care being exercised to 
learn of what the colors are composed in the substituted paint or 
wash. The general results of this blood poisoning are fevers, erup- 
tive diseases, debility and choleraic diarrhoea, not to mention its pre- 
paration of the system for the reception of contagion and epidemic, 
and by prostration of strength inducing fatal results in attacks not 
of themselves dangerous. 

WATER. 

Water becomes dangerously impure chiefly under these conditions: 

1. When some localities in a town or village are at low levels as 
compared with others and are so situated as to receive the drainage 
of these other localities. 

2. When the drainage is radically defective, the drains and com- 
mon sewers being so constructed as to leak into the sub-soil or to be- 
come choked and to overflow from time to time. 

3. When the drainage, though well constructed, takes place into a 
river or stream, and the water supply comes from the same river or 
stream and within the poisonous influence of the sewage. 

4. When there is no system of drainage at all, properly speaking, 
but a system of cesspools ; when impurities are allowed to accumu- 



134 HYGIENE. 

late superficially on the soil, and the soakagc from the cesspools dif- 
fuses itself Mid ly through the suhsoil so as to contaminate the wells 
from which the water supply is derived. 

The purer the water, that i-, the freer it is from earthy salts which 
impart hardness to it, the more easily does it become impregnated 
with metal. Especial care must be used, and lead cisterns must be 
avoided. You must always remember likewise to allow the water 
that lias been undisturbed in the lead pipes all night, to run awhile 
before drinking of it in the morning, or before filling up the kettle; 
for boiling does not get rid of the lead or render it less hurtful, as it 
does, no doubt, some organic impurities. 

Most of you in cities have only to go to the tap for water when 
you want it, but in some cases in the country it has to be kept for a 
time. If so, never leave it about in open vc ssels, for dust will fall 
into it, and it will absorb various substances from the air. To illus- 
trate this, I need only mention the common practice of putting buck- 
ets of water into a newly painted room to take the smell of the paint 
away. It certainly d >es that to a great extent, and if you examine 
the water you find that it soon smells strongly of the paint, showing 
how absorbent water is. Tliink, too, what is meant by the dust of 
an inhabited room. It is composed of minute particles — I was going 
to say of everything — but certainly of everything that can be rubbed 
off our clothing, and from the walls of the room, and t:;e furniture, 
and also from our own bodies. 

Keep it, covered, therefore, not in metal vessels of any kind, nor in 
wood, but in glazed earthenware or stoneware jars with lids to them. 
And empty these now and then, and thoroughly cleause them. Use 
iron utensils for cooking, and never have them repaired with lead 
solder, as the lead will poison the water to some extent. Supposmg 
that the supply of towns' water has been stopped for a time, run a 
pood deal of it off before using it, and see that it is bright and clear. 
Thi>< brightness is by no means a proof of its purity, but all good 
Wilier is bright and elear, so that if it should be muddy or turbid 
you know it is not fit to drink. 



CISTERNS. 135 

"Water should be free from all smell, and should have no definite 
taste ; but you should always, however bright it may look, use a 
filter, which separates, at any rate, all mechanical impurities. 

CISTERNS. 

A model cistern is made of brick and cement. If the walls are 
four inches in thickness it should be cone-shaped ; the pressure of 
the surrounding dirt will then add to its strength. If the walls are 
thicker the diameter may be the same from bottom to top, or the 
upper portion contracted, making it bottle-shape. The excavation 
should be at least two feet greater than 1he proposed side of the 
cistern. The brick should be well covered with cement on the out- 
side as the work progresses and sufficiency long in point of time be- 
fore filling is begun to receive careful inspection. The top should 
be carried at least one foot above the surface of the ground so as to 
prevent admixture with surface-water. When the brick work is 
finished the inside should receive two or three layers of cement. 
When set, the bottom should be cleaned and well covered with 
cement. Over this should be laid a layer of brick, and over the brick 
a thick cement. Such a cistern is perfectly water-tight and its con- 
tents cannot be contaminated by neighboring pools or water-courses, 
noxious deposits upon the ground, or contiguous privies. Care 
should be taken in the selection of cement. Portland is the best. 
The bricks may be odds and ends or even second-handed. Wood of 
any kind should not be used as it quickly decomposes and charges 
the water with poisonous substances, which produce fevers, chills and 
diseases of the bowels and blood. More so-called " malaria," sum- 
mer complaints, dysentery and serious fevers of a typhoid character, 
are caused by Ubing water charged with decaying and animal matter, 
than are produced from any other source. 

PURE AIR. 

Thcugh we eat three times a day we breathe 25,000 times in twenty- ' 
four hours ; with every breath we draw, we take into our lungs about 



136 HYGIENE. 

one pint of air; the truth then is that eating and drinking may be 
considered as secondary or supplementary functions in the compli- 
cated process performed by that living engine called the b <dy, while 
the more important task falls to the share of the lungs. The stomach 
may suspend its labors entirely for twenty-four hours without serious 
deirimeut to the system, while the work of respiration cannot be 
interrupted for six minutes without fatal consequences. — (Dr. F. 31. 
Oswald.) 

The air is poi?oned by carbonic acid gas ; traces of it are always 
found. It is the lile of the plant and of vegetable growth, but in the 
proportion of oue part in a hundred it is dangerous to animal life. 
In crowded assemblies this proportion is often exceeded. Interest in 
the subject, the eloquence and magnetism of the speaker, do not in 
some instances counterbalance the poison, and the hearer falls asleep ; 
besides, in this condition, respiration is less active and hence less 
of the contaminated atmosphere is inhaled. This poison is caused 
by the escape of the gas from the lungs. All combustion produces 
it. It is rapidly generated by fires, but is carried away by the ascend- 
ing heat and draft. "When the draft is deficient, it passes into the 
room. In its pure state it is heavier than air and hence falls to the 
floor or ground. It d< es not remain there, however, for it is a law 
of nature that gases shall commingle. They seem to have an affinity 
for each other. This poison, therefore, soon pervades the whole 
room and enclosure. Analogous to this are the gases from improper 
combustion noticed upon going into a room where the flame of the 
lamp has been so diminished as to create but little draft in the chim- 
ney or where the last of the contents of the lamp is being consumed; 
from coal-gas seen in its effects Upon silver, leather binding of books, 
etc., and from defective chimneys. 

The atmosphere is des^poiled of its purity by the noxious vapors 
arising from animal and vegetable decay. "With these may be classed 
the effluvium from slaughter houses, from dead animals, from decay- 
ing haves, herbs and vegetables in cellars, from rotting wood about 
door-yards and in village walks, the deposit of animals in barn- 



IMPURITIES m THE AIR. 137 

yards and in the streets of cities, from privies and the noxious exha- 
lations from drains, sinks, cesspools, sties, coops and stables. 

Pettenkofer and Coit found that exposure to air containing ten 
parts per thousand of carbonic acid gas could be borne with impu- 
nity for a long time, if it were pure in other respects. But in 
occupied rooms many people suffer from headache and giddiness 
when the carbonic acid gas is any more than one and one-half per 
cent, per thousand, probably in great part from the presence of 
organic impurities, and also from the diminished proportion of 
oxygen. 

Many of you may know the story of the 146 prisoners — English 
people — who were confined in the "Black-hole of Calcutta," and of 
whom 123 died in one night, while many of those who survived 
afterward died of " putrid fever." No doubt many were suffocated, 
but the fever which attacked the survivors was caused unquestion- 
ably by the exhalations from so many crowdt d together in this living 
tomb. The history of our own country even up to quite recent 
times, shows that the same cause has often been at work. 

John Howard, the philanthropist, says that in his day " the malig- 
nity of the air in gaols" was such that in his first journey his clothes 
were so offensive that he could not bear the windows of a post-chaise 
up, and was often obliged to travel on horseback, and the leaves of 
his notebook were so offensive that he could not use it until it had 
been open an hour or two before the fire. 

Persons working in factories, such as flouring mills, planing mills, 
foundries and the like, where the atmosphere is loaded with dust, 
should breathe entirely through the nose, and the nostrils should each 
be filled with a piece ot moistened sponge or covered with the 
Respirator. Those who have not tried this will be surprised at the 
amount of dust collecting in a single hour. 

Pure air will avert scrofula and consumption, cure cholera and 
typhus, and mitigate the violence of any disease. It is the best, the 
* most thorough disinfectant in existence. The contagion of small- 
pox, scarlatina, diphtheria, measles, dysentery, cholera, typhus, all 



138 nYGIEXE. 

are neutralized and made innocuous by immersion in pure air. One 
reason of prolonged sickness is the continued breathing, by the 
patient, of the exhalation of his own lungs and body. 

Dr. Paul Niemeyer says: " It has long been held that closed win- 
dows are the principal cause of consumption. I would make the 
proposition more general by substituting defective ventilation for 
"closed windows. " It is very pleasant to be sheltered by four wa.ls 
against wind, rain and cold; but, now that we employ window-glass, 
coal for heating and iron stoves, and rent is becoming higher, while 
rooms, especially sleeping-rooms, are growing smaller, we have all 
the greater reason to keep open ventilating apertures, since our lungs 
cannot live with less than s.x hundred feet of fresh, pure air per 
hour. The man who has but once made trial for one week of sleep- 
ing with the window open will never give up the practice. 

" More rational opinions are gradually making their way, and in 
one partictdar at least a beginning is being made of a revolution; 
namely, the system of treatment followed in ' climatic ' sanitariums, 
and establishments for the cure of disease, by air, difference of eleva- 
tion, etc. The proprietors of such places, it is true, speak of the 
'specific' virtues of their climate; but, inasmuch as chemistry shows 
that atmospheric air all over the earth has the same constitution, the 
specific virtue must reside in the special purity of the air — a thing 
wanting in cities, but found in all villages provided they do not pos- 
sess large factories." 

But air is not pure and beneficial by virtue solely of its freedom 
from contaminating elements. It needs to be shone through daily, 
actinized, vivified by the sun. Scrofula, tubercle and a swarm of 
other maladies are engendered by living in the shade. We have all 
witnessed potato-vines growing in a cellar: how watery, white and 
tender they were. Human faces are bleached and human bodies are 
made fragile in the same way. Sunshine is as beneficial for human 
blood ms for the top of a tree or plant. We make an allowance for 
the torrid days of summer; but even then the light can be enjoved. 
A sleeping apartment which is not daily lighted through, as well as 



VENTILATION. 139 

aired, is a chamber of pestilence. With rooms darkened by shades 
and curtains, carpets contaminating the air and wall-paper of ten little 
less mischievous, all care being taken to save the furniture, over- 
looking the inhabitants, we can expect only sickly persons, half sick 
when reputed well and tediously valetudinarian always. 

VENTILATION. 

For cold weather the plan introduced by Dr. H. A. Dodge is val- 
uable : — 

Nail or screw a neat strip of wood, from one to two inches high, upon 
the window sill, just inside of the sash, and extending entirely across 
from one side of the window frame to the other. Upon the top of 
this strip fasten a piece of ordinary • weather strip,' so that there 
will be formed an air-tight joint between the weather strips and the 
lower sash of the window, whether the latter is shut down tight or 
raised an inch or two, the lower crosspiece of the sash sliding on the 
rubber of the ' weather strip ' as the sash rises. With this simple 
fixture in place, the lower sash may be rais< d enough to admit a 
stream of air between the lower and upper sashes, where they lap 
over each other at the middle of the window, without admitting the 
least air at the window sill. The air admitted between the sashes is 
thrown directly up toward the ceiling, and then mixes with the heated 
air at the upper part of the room. The room is thereby ventilated 
in a thorough and agreeable manner without draughts of cold air 
upon the persons in the room. The fixture should be applied to sev- 
eral windows in the room. The amount of ventilation may be regu- 
lated by the distance that the lower sash is raised. This arrangement 
is cheap, simple and effective. 

VENTILATION OF BED ROOMS. 

The sleeper, like a bed-ridden person, is entirely dependent upon 
the atmosphere supplied to him for the means of carrying on the 
chemical purification and nutrition of his body. He must breathe 
the air that surrounds him, and he does this for several hours, 



140 HYGIENE. 

although in a majority of eas s the atmosphere has become so dete- 
riorated by the expiration of carbon and the emanations from the 
bodj generally, that if the senses were on the alert some change 
would be sought as a mere matter of preference. When a person 
places himself in a condition to take in any and all air, without being 
able to exercise any control over its delivery, he ought to make sure 
that the supply will be adequate, not merely for the maintenance of 
life but the possession of health. If a man were to deliberately shut 
himself for six or eight hours in a stuffy room, with doors and win- 
dows clo.-ed, and were then to complain of headache and debility, 
he would be justly told that, his own want of intelligent foresight 
was the cause of his suffering. Nevertheless, thi3 is what the great 
mass of people do every night of their lives with no thought of their 
imprudence. There are few bedrooms in whi< h it is properly safe 
to pass the night without something more than ordinary precautions 
to secure an inflow of fresh air. The old-fashioned fire-place with 
its open chimney was the correct thing, but we are wise in our day 
and generation, and have got beyond all that. If the doors have 
transoms, we can look to these and the windows for ventilation, but 
I fear that in general we all have to rely upon the windows alone. 
Summer and winter, with or without fires, it is best to have a free 
ingress for pure air. Foul air will find exit, if pure air is admitted 
in sufficient quantity, but it is not certain that pure air will be drawn 
in if the impure is drawn away. The aim must be, to accomplish the 
object, without, causing a great fall of temperature or a draught. 
The upper sash may be drawn down an inch or two with advantage, 
and a fold of muslin will keep off the draught. Another plan is to 
raise the lower sash two or three inches, insert a board under it, 
leaving the space between the sashes at the centre of the window open 
for ventilation or, if a permanent fixture is desired, use that above 
described. Either has the advantage of not throwing the stream of 
air directly into the room. It is, however, essential that the air out- 
Side should be pure. Little is likely to be gained by letting in fog, 
or even the city mist, smoke and dust. 



ANOTHEK FACTOR 141 

SUNLIGHT. 

Light is one of the most active agencies in enlivening and beauti- 
fying home. As great as is the value of sunlight as a life-giving 
agent to the physical constitution, it is no less so to our own moral 
and spiritual nature. We are more active under its influence ; and 
think better and act more vigorously. Let us take the airiest, choicest, 
sunniest room in the house for our living room — the workshop where 
the brain and body are built up and renewed — and there have a bay- 
window, no matter how plain in structure, through which the sun- 
light and pure air can freely enter. Dark rooms bring depression 
of the spirits, imparting a sense of confinement and isolation and 
powerlessness which is chilling to energy and vigor, but in light 
rooms is good cheer. Even in a gloomy house where the walls are 
dingy and brown we have but to take down the heavy curtains, open 
wide the window, hang brackets on either side, set flower-pots on the 
brackets and let the warm sun stream freely in to bring health to our 
bodies and joy to our souls. 

Among those making hygiene a study, sunlight is regarded as 
equally valuable as pure air, both in maintaining health and in re- 
storing it during invalidism. 

A New York merchant noticed in the progress of years each suc- 
cessive book-keeper gradually lost his health and finally died of con- 
sumption, however vigorous and robust he was on entering his 
service. At length it occurred to him that the little rear-room where 
the books were kept opened on a back-yard so surrounded by high 
walls that no sunshine came into it from one years' end to another: 
an upper room well lighted was immediately prepared and his clerks 
had uniform good health ever after. A familiar case to general 
readers is derived from medical works where an entire English family 
became ill and all remedies seem' d to fail of their usual results when 
accidentally a window-glass of the family room was broken, in cold 
weather. It was not repaired, and forthwith there was a marked 
improvement in the health of the inmates. The physician at once 
traced the connection, discontinued his medicine and ordered that the 



I 



112 HYGIENE. 

window pane should not be replaced. A French lady b came ill. 
The most eminent physicians of her time were called in, but failed to 
restore her; at length Dupeytren, the Napoleon of physic, was con- 
sulted. He noticed that she lived in a dim room into which the sun 
never shone: the house being situated in one of the narrow streets, 
or rather lanes, of Paris. He at once ordered more air and cheerful 
apartments and all her complaints were abolished. 

Instances are without number where the health officers in the city 
of New York, during the heated term of summer, while visiting the 
more thickly populated tenements, found the confined air of rooms 
where children were suffering from cholera infantum, was not only 
stifling, but shutters and blinds were brought into use to keep out the 
heat and with it the sunlight. By removing them, creating a draft 
through the rooms and allowing plenty of sunlight, improvement 
was noticeable in many cases and in most the result was immediate. 
The lungs of a dog become tuberculated (consumptive) in a few 
weeks if kept in a dark cellar. It is a well-known fact that most 
plants become weak, pale and straggling if no sunlight falls upon 
them. For many other reasons than the topic we are now treating, 
our houses, or rather the manner in which they are occupied, should 
be turned upside down. The kitchen and laundry should occupy the 
attic story; the basement, which is used for dining room and kitchen 
and in many cases being occupied as a sitting room, although not 
intended for such, should be used for the storage of coals, rubbish, 
etc. , and for furnaces. 

BATHTNG. 

When the surface of the body is wetted with cold water the skin 
contracts, the size of its blood-vessels becomes diminished, and part 
of the blood which would have circulated through the skin is sud- 
denly sent to the deeper organs. The nervous system is also stimu- 
lated, the breathing becomes quicker, and there is a more energetic 
action of the heart and blood-vessels; consequently there is a rush of 
blood back to the surface, producing the flushing and sense of warmth 



BATHING, 143 

familiar to all. This condition, the "reaction," is the first object 
and purpose of every form of bathing. By the reaction, the in- 
ternal organs are relieved, the breathing is lightened, the he art is 
made to beat freely, the mind feels calm and strong, the tone of the 
muscular system is increased, the appetite is sharpened, and the 
whole organism feels invigorated. If this reaction does not come 
on quickly the mode of bathing adopted can do no good, and may 
even be unsafe. The man or woman whose fingers or toes become 
blanched and benumbed for a time after bathing is not in a fit state 
of health for the particular sort of bath that has produced such a 
result. Some other less trying mode should be employed. 

When a man gets up out of a warm bed and tumbles suddenly 
and without any preparation into almost ice cold water, ■ I con- 
fess I consider it a feat to wonder at rather than imita e. Such 
bathing is the result of training and belongs in the category of gym- 
nastics. It is one of the fantastic tricks that men play with their 
constitutions, like walking a thousand miles in as many hours, run- 
ning races that would be trying for a greyhound, or allowing people 
to break paving stones on their chests. The only quite safe bath for 
an ordinary man or woman, without training, for all the purposes 
of cleanline s, and for bringing on the reaction, is cold sponging, 
eiiher with or without previous hot sponging. The process can be 
varied in many ways, according to the feeling and state of health of 
the bather, and no one need cease to have baths altogether because 
too delicate for the common practice, or because there is not a bath- 
room in the house. All that is required is an ordinary portable bath 
or a large "mug." A small quantity of warm water maybe put 
into the bath, just enough to keep the feet warm. Then the cold or 
cool water supplied from a basin or the tap is to be applied by a 
sponge to the nape of the neck, in order to send a stream down the 
hollow of the spine, and this complete* the process. Everything, in- 
cluding the process of drying, should be done without loss of time. 
This is all that is necessary for health. A man who is ambitious and 
very robust may reach the profoundest depth of a plunge without a 



144 HYGIENE. 

fit of apoplexy ; but there is no evidence to show that he is better off 
than hi> less ambitious contemporary who acts more cautiously. 

INDOOR EXERCISE. 

We believe that Wood's Parlor Gymnasium offers the most com- 
plete system of physical exercise ever devised for home practice. 

The fallowing are a few of the advantages derived from its use : 

It calls into direct action all the muscles in the upper part of the 
body, and chiefly those which are generally neglected by persons of 
sedentary habits. It corrects the stooping posture so frequently 
noticed in young persons, and imparts an uniform degree of strength 
to the muscles supporting the spinal column. 

To those who are afflicted with dyspepsia, indigestion, nervous 
debility, weakness of the chest, lung and liver complaints, etc., it 
may be u^ed with certainty of the most gratifying results. 

It can be graduated to the use of the strongest man or the weakest 
child ; is admirably adapted to the use of invalids and convalescents, 
where general exercise is desirable. To ladies and children especially 
the exercise will be found of the most invigorating character. 

It can be attached to the doer-casing of any room, requires but 
little space, ar.d can be taken down when necessary in a moment. 

It is highly recommended by leading physicians and all those who 
have made the subject of physical exercise a study. 

It is easily adjusted to any room. The directions for putting up 
are simple: 

Insert one of the screw hooks into the door-casing about eight feet 
from the floor. Place another into the floor directly under and on a 
line with the upper one, and about 3 to 4 inches from the wall. Use 
a small gimlet to make the holes. The lower hook is intended to 
receive the rincr into which all the rubber springs are attached. The 
Upper one receives the ring attached to the i-on pulley. 

The small holes in the side of the pulleys are intended to receive the 
oil necessary lo lubricate the wheel, one drop being sufficient at a time. 

To demonstrate its range of movements and as a guide to those 



EXERCISE. 



145 



who now do or may hereafter possess the Parlor Gymnasium, a de- 
scription ot a tew exercises are inserted. 

Exercise 1. The performer will grasp a handle in each hand and 
take a position about four feet in front facing the instrument, right 
foot in advance Keep the arms perftctly straight, (knuckles up,) 
and by a quick and vigorous pull down, force the arms as far back as 
possible, see fig. 1, (solid part,) then swing the arms quickly forward 
and repeat the movement twenty 
times. K B. At first each move- i 
ment should be executed twenty 
times, but with practice they may 
be increased to one hundred. The 
resisting power of the spring may 
be increased by simply taking a 
position a little farther from the 
instrument, or it may be weak- 
ened by removing one or more 
strands from the snap hook E. 
Thus a child may use one strand, 
a boy or girl two, and a lull grown . 
person all three. 

Exercise 2. Separate the han- 
dles right and left, keeping the 
arms perfectly straight, and forc- 
ing them on a line horizontal with 
the shoulders, as seen in dotted Fig. 1. 

srms fig. 1. The movement may also be executed by carrying one 
arm forward while the other is going back. 

Exercise 3. Swing the arms upward over the head, throwing the 
shoulders back and bending the left knee, as seen in fig. 1 (dotted lines. ) 

Exercise 4. Combinations of first and third movements executed 
alternately ; as the arms are brought down to the front, the body is ( 
inclined forward, and when carried up over the head it is inclined 
backward. 
7 




146 



HYGIENE. 



Exercise 5. Place the heels together, keep the legs perfectly 
straight, bend the body forward, and force the handles down towards 
the feet without bending the knees.then spring up and throw the arms 
over the head, bending the body slightly back. Repeat the move- 
ment twenty times. 

Exercise 6. Pull both hands simultaneously to the right side, 
turning the body in the same direction, but keeping the feet firmly 
in position, toes pointing to the front, 
see fig. 2. Repeat the movement 
twenty times, then carry the arms to 
the left the same number ; finally 
swing them right and lef i alternately. 
Be careful to keep the hotly erect and 
avoid bending downward. A quick 
and vigorous pull will be necessary in 
order to force the handles well back 
and it is also desirable that the move- 
ments be executed with considerable 
rapidity. 
Exercise 7. The performer will 
r take position seen in fig. 3, dotted 
lines, feet well apart and the left in 
Fig. 3. advance. Swing the right arm over 

the head, at the same time half face to the right, throwing the weight 
of the body upon the right leg, bending it at the knee, and force the 
handle well forward. (See tig. 3.) The hand must be carried well 
back over the In ad to allow the cord to come down behind t he 
neck. Return to first position, and execute the movement twenty 
times, then place the right foot in advance and swing the lef t arm 
over the head the same number. 

EXERCISE 8. Take position with the back to the instrument, right 
foot in advance;, body well braced by the left leg, and arms perpen- 
dicular over the shoulders, see fig. 4. Force the handles forward and 
down without Lending the elbows, incline the shoulders forward and 




EXERCISES. 147 

push the handles as far to the front as possible. Return to position, 
but be careful in raising the arms not to relax the muscles too sud- 
denly, otherwise the springs will pull the body backwards and off 
balance. Repeat the movement twenty times. 




Fig. 3. 

Exercise 9. Take position as in last exercise, placing the arms as 
seen in dotted lines downward, pull the handles forward at arm's 
length until the cords are brought up under the shoulders, swing the 
arms back to position and repeat the movement twenty times; the 
arms may also be brought forward alternately. 

Exercise 10. Combine the last two movements in one, describing 
the arc of a circle with the handles; keep the arms perfectly straight, 
incline the body forward as the arms are extended to the front; sepa- 
rate the hands sufficiently to allow the cords to pass outside of the 
shoulders without touching them. Execute this movement slowly at 
first unt ; l a correct uniform motion is obtained. 

Exercise 11. Take position as in exercise 9. but raise the arms a 
little higlier; separate the handles right and left, force the arms to a 
horizontal line with the shoulders, continue tie movement forward 



148 



IIYGIENE. 



until the handles are brought together at arm's length in front of the 
chest, the cords resting against the shoulders, then separate the arms 
right and left, and swing back to position. This movement may ;il>o 
be performed by bringing the arms forward alternately, keeping them 
perfectly straight. 




Fig. 4. 



EXERCISES. 



149 




Fig. 5. 



Exebcise 12. The performer will take position seen in solid part 
of fig. 5. Elbows well back and hands close to the body under the 
shoulders, right foot in advance ; ^ 
extend the arms to the front and 
throw the shoulders forward twen- 
ty times. Keep the feet firmly in 
position; in returning brace the 
body well up with the left leg to 
avoid being pulled backwards. 
Execute the movement alternate- 
ly, first extending one arm, and as 
it returns extend the other. 

Exercise 13. Take position 
f acingtheinstrument at a sufficient 
distance to put a slight strain upon 
the spring, the arms as in dotted 
lines, see fig. 6. (The performer 
will observe that the instrument has been inverted, the spring be- 
ing attached to the upper hook and the pulley to the lower one ; 
by this arrangement we gain some very valuable exercises.) By a 
quick pull upwards at arm's length carry the handles over the 
head, at the same time -incline the shoulders backwards, throwing 
the weight of the body on the left leg. It will be observed that the 
knuckles are up at the starting point in the figure, but the movement 
may also be executed with the knuckles down, or alternately up 
and down. 

Exercise 14. The performer will take position with the back to 
the instrument, arms as in dotted lines, fig. 7. Elbows close to the 
body and hands in front of the shoulders. Extend the arms forward 
and up, moving the body well forward upon the advanced leg ; in 
returning to position brace the body well up to avoid being pulled 
backward. The movement may also be txecuted by extending the 
arms barkward instead of holding the hands in front of the shoulders, 
or the arms may be thrown forward alternately, 



150 



HYGIENE. 




Exercise 15. This movement 
is similar to, and brings into 
action all the muscles affected 
by pulling a pair of oars. The 
pupil will take a seat upon the 
floor or low bench (an ottoman 
will answer the purpose admira- 
bly,) legs extended to the front; 
stretch the arms well forward 
towards the feet, then pull the 



Fig. 0. 
handles well back until they are on 
a line with the chest ; bend the body ' 
well backwards, but be careful not /y 
to overbalance it. The instrument 
must be in the inverse position, as 
in Exercises 13 and 14. 

Many oilier movements may be 
executed upon the Parlor Gymna- 
sium ; a variety of new combina- 
tions can readily be created by the Fig. 7. 
performer, according as fancy may dictate or taste direct, but suffi- 
cient has been given to develop the resources of the instrument. 

In the Parlor Gymnasium is the means for imparting a good 
f undition for health and vigor, and that enjoyment of life to which 
none but the healthy Can aspire. 




RESULTS OF EXERCISE. 151 

A few words with reference to the best time for exercise. A very- 
free and general use of the Gymnasium may be indulged in before 
performing the morning's ablution, and also before retiring at night. 
The middle of the day is considered by physiologists the best time 
at which the greatest amount of exercise should be undertaken ; but 
if this hour is not convenient, then during the evening, as the mus- 
cles, if fatigued by the exercise, will sooner have opportunity for 
rest. 

To those who are unaccustomed to Gymnastic Exercises these 
movements wili have a peculiar effect at first, but regular practice 
for a week or two will terminate all disagreeable feelings of the 
muscles. 

When these exercises are undertaken as a restorative, it is of the 
utmost importance to guard against exposure ; never suffer the open 
pores to be too suddenly closed by cold. A copious ablution with 
cold water and sponge, and then a hearty friction with a rough towel, 
has in all cases a bciieik ial effect. 

RESULTS OF EXERCISE. 

Dr. Burcq of Pari?, as the result of minute investigations, comes to 
the following conclusions in regard to the capabilities of physical 
growth by gymnastic exercises. 

First. An increase of one-third and even one-half in muscular force, 
with a tendency to an equi ibrium between each side of the body. 

Second. An increase of at least one-sixth of the pulmonary 
capacity. 

Third. A diminution in volume simultaneous with an increase in 
weight, equal to about fifteen per cent. This increase is confined 
exclusively to the muscular system. 

The average muscular strength of women is scarcely half that of 
men; while at the same time there are individuals of the weaker sex 
who approach much more n- arly the strongest among men, and who 
exced considerably the average strength of men. 

Women till the soil in France, wheel coal in Belgium, push loaded 



152 HYGIENE. 

hand-carts in Germany, and pump water and carry bricks and mor- 
tar up ladders in Austria. 



How often we have execrated the officiousness of friends and 
attendants, who aroused invalids from sleep to give them food or 
medicine, or who awakened those who were exhausted to eat dinner 
when the sleep was more precious than the food. There is no econ- 
omy of time or life, and certainly not of health, in these days, in 
abbreviating the period of repose. Much of the early rising enjoined 
in books is humbug. Our first acquaintance with dyspepsia was the 
result of being kept awake of nights, one season when young, on 
purpose, by a companion who had a whim that we slept too much 
for our spiritual welfare. It had the ulterior result of leading us 
outside of that sort of religion, as well as of improving the nervous 
and digestive systems. 

Even sleeping in church or in crowded assemblies is often bene- 
ficial ; a person breathes less when asleep and is not so liable to be 
poisoned with bad air. 

Our favorite panacea for ailments is sleep. With the illustrious 
Sancbo we invoke blessings on the man that invented it. Dr. Young 
was critically correct in styling it ''tired nature's sweet restorer." 
Emanuel Swedenborg declared that in sleep the brain folded itself 
up and the soul journeyed through the body repairing the wastes of 
the previous day. The effect on the mind is even more wholesome. 
If we have been shamed, insulted, worried, grieved or angered, so 
that the blood is poisoned, sleep soothes the spirit, relieves the an- 
guish, refreshes and cleanses away the soil of acquired foulness. 
Insane persons are in a fair way of recovery when they sleep naturally. 
In sleep the sick become convalescent, ulcers granulate and lesions 
are made whole. So true is this that ulcers, otherwise so intractable 
as to be supposed incurable, are induced to heal by keeping the patient 
under the influeuce of opium. When we are weary and exhausted 
we are feverish. Bathing and eating to a certain degree relieve this 



AFTER-DINNER NAPS. 153: 

condition, but never completely. Yet plenty of sleep will tnable us to 
do with less food. '.' Who sleeps, eats " is a French proverb. Horace 
Greeley died for want of sleep. (A. Wilder, M.D.) 

AFTER-DINNER NAPS. 

No wonder if half the world knows how pleasant it is to take an 
after-dinner nap and what a relief it is to the overburdened brain or 
stomach. We used to know a lawyer who took his nap every day 
after dinner on three chairs, and that lawyer, if he continues the 
practice, will die an old man. If there is any one time when a man 
is forced to exert himself to work, whether in muscular or brain 
labor, it is after the noon-day meal. If all men could only rest, not 
one hour but two hours, and put the extra time on the closing hours 
of the day, what an improvement would be made in their health. 
Whether he be a farmer or a mechanic, or a professional man, a good 
rest after dinner leaves the man in a better condition for hard labor 
than even in the morning. 

We once worked for a farmer in harvest, who always made an 
agreement with his workmen to work ten hours a day, and from 
twelve o'clock till two no work was to be done unless in case of 
emergency, a threatened rain or something that required extra 
exertion. Didn't we have glorious times sleeping under trees after 
dinner 1 We always used up three-quarters of an hour at the table 
and then slept one hour and a quarter during the heat of the day. 
The result was the men were never overworked and the farmer got 
more labor from his men than any of his neighbors, though their 
men often worked twelve hours a day. When two o'clock came the 
hands were all in good trim, completely rested out and they could 
do double the work with more ease than if they had commenced 
work at one o'clock. A single hour's rest at the proper time worked 
wonders with them. (Peoples' Ledger.) 

SLEEPING TOGETHER. 

Parents and friends ought to oppose as much as in their power the 
sleeping together of old and young persons, of the sick and healthy. 

7* 



154 HYGIENE. 

An old weak person near a child will in exchange for health only 
return weakness. A sick mother near her daughter communicates 
sickly emanations to her; if the mother has a cough of long duration, 
the daughter will at some time also cough and suffer by it; if pul- 
monary consumption, it will be ultimately communicated to her child. 
It is known that the bed of a consumptive is a powerful and sure 
source of contagion, as well for men as for women and the more so 
for young persons. It need not necessarily be a contagious disease 
as generally understood. Debility is " catching " and one disease 
may develop another in the sleeping companion. 



The following requisites should be met in order that our apparel 
may be the most conducive to health : 

1st, Equable irarmth and protection. Garments should not be 
doubled about the waist or abdomen, as is now so common with 
both sexes. 

2d. The warmth necessary in cold weather should be secured with 
the leaM amount of weight. To double and triple the amount of 
clothing about the chest, shoulders and neck, does not increase gen- 
eral warmth, but simply overheats a single part. 

3d. It should be so loose as to permit of the freest motion in every 
direction. Respiration will then be facilitated and the superficial 
circulation of blood be free and undisturbed. 

4th. The dress should be so constructed and fastened as to be put 
on and removed with tJie greatest facility. In time of fire and occa- 
sions when from pre?s of business, si kness in the family or other 
causes, the amount of time given to sleep is necessarily limited, the 
gain is evident. Sleep is both sounder and more refreshing when 
th clothing worn for hours, is changed for the night dress. Clothes 
easily changed cause the least annoyance and fatigue upon retiring, and 
allow easy adjustment by the physician in case of injury or accident. 

nth. Clothing must be abad conductor so as to store up in itself the 
heat that leaves the body, and thus transfer the point from which 



CLOTHING. 



155 



our heat radiates from the surface of the skin to the outside of the 
clothing, or to some point in its substance. Experiments have proved 
that material made of silk or cotton allows more heat to pass through 
it than material made of wool ; and so the woolen material is better 
than silk or cotton as clothing. Again', it has been proved that any 
material wheu on the stretch, by being tightly drawn, allows more 
heat to pass through it than when it is loose ; and further, it has 
been found that by leaving some space, say from one-third to one- 
half an inch, between two layers of the same material, it lessens 
very considerably the outward flow of heat. This space of from 
one-third to half an inch may be taken to represent the space be- 
tween comfortably fitting garments; and therefore we learn that to 
draw our clothes tightly round the body is to deprive them of a large 
proportion of their power of preserving our heat ; and so if we wear 
our clothes tight we shall require more of them to keep ourselves 
warm than if they fitted more closely. In proof of this is the effect 
of tight gloves and boots upon the hands and feet in winter. 

Again, our clothing must allow free ventilation of the skin. This 
may seem contrary to your ideas, for clothing is generally considered 
necessary to keep the air from us, whereas it has been proved by ex- 
periment that those clothes which allow most air to pass through 
them keep us warmest. If our clothing kept us warm in proportion 
to the power of excluding air from the body, kid would keep us a 
hundred times warmer than flannel, while every one knows by expe- 
rience that it is quite the reverse. Successive layers of the same 
material have very little influence in diminishing the ventilation, so 
that while we use several layers of woolen clothes to prevent radia- 
tion, we do not interfere with the proper ventilation of the skin. It 
is by interfering with such ventilation that waterproof fabrics are so 
unpleasant and dangerous to wear. 

There is another point which it is necessary to consider as regards 
our clothing, viz., the effect which water has upon it. It is evident 
that all textures lose their ventilating and increase their conducting 
power, more or less, when wet. Linen, cotton and silk, soon be- 



156 HYGIENE. 

come air-tight by wetting, whereas flannel becomes so only after a 
long soaking. This explains why we feel so much colder, and take 
cold more readily with a wet linen than with a wet flannel shirt next 
to the skin. 

He who walks must be clo'ked differently from him who drives, 
and she who dances from him w T ho pipes; but when the walker stands 
and the dancer ceases to dance, they should have extra covering to 
prevent a chill. 

The clothes shoulJ sit comfortably on the body, all weight being 
suspended from the shoulders alone, and whoever feels any oppression 
from his clothes, even on the shoulders, may rest assured that he is 
either improperly clothed or the subject of some unsuspected 
disease. 

It is a sad sight to the physician's eye to see a child from two to 
six years of age with no protection or covering to the legs between 
the knee and ankle. 

With the exceptions of the head and feet, the remainder of the 
body is over-heated. A fine flannel suit for summer and heavier for 
winter should cover the whole body, except the head, neck, hands 
and feet, and the latter should be well and comfortably clothed. 
"We repeat, keep the feet warm. 

We dress by the calendar to an insane extent, instead of going by 
the actual state of the weather. We are always disappointed with 
our spring season. Isolated fine days induce us to doff our warm 
clothing, in spite of repeated experiences of the variable nature of 
our climate and its consequences. These consequences, however, 
affect not the skin itself so much, but the various organs of the 
body through the skin, appearing in one as congestion of the lungs, 
in another as a quinsy, in another as a cold in the head. 

Change of clothing must depend on the habits of the individual ; 
but however much anyone may wash, the underclothing ought to 
be changed every week. The flannels absorb the perspiration, and 
if the skin be not regularly washed the flannel becomes full of 
refuse matter, and at the same time loses its power of retaining 



WOMEN'S DRESS. 157 

heat. Those who wear their underclothing too long, and do not 
wash their bodies frequently, become walking nuisances, continually- 
evolving noxious effluvia. When any number of such individuals 
meet in a room, the atmosphere is quickly rendered unpleasant to 
the sense of smell — and when air can be smelled it is bad indeed. 

women's dress. 

The invalidism and consequent uselessness of women is increas- 
ingly apparent. And yet while the fact is generally acknowledged, 
and, by some, accounted for, great is the wonder when bright 
young girls become afflicted with some disease common to the sex. 
The surprise would vanish if one would estimate that five, ten, 
twenty or more pounds of dress goods were closely girded around 
the waist, dragging upon the delicate, easily-displaced organs 
within. The horror awakened by this fact would be increased if 
one would further consider that it is as unusual for a woman to 
have a natural form, as for a man to have an unnatural one ; that 
a woman's form is shaped in an unnatural mould by a stiff, narrow- 
waisted corset ; that this thing and about twenty thicknesses of 
other material in the form of gathers and bands produce heat 
enough about the waist to keep the internal organs in a state of 
inflammation ; that the extremities are thinly covered, and in win- 
ter are liable to cold or wet ; and that the clothing generally is so 
arranged that the free use of the limbs in any actiye exercise is im- 



But though a perfectly fashionable attire is so evidently a weari- 
ness to the flesh, yet women — especially the young a-d fashionable, 
are slow to adopt a sensible reform. It is much to be desired that 
such could hear the experience of those that have suffered, and learn 
that they cannot lay one destructive finger upon the temple of their 
bodies without paying for it in pain and anguish ; that to women 
who have weakened and deformed their bodies by tight waists and 
heavy skirts, the physical trials which come to most of the sex are 
agonizing, exhausting, and often fatal. If they knew all this they 



158 HYGIENE. 

would admit that ihe shoulders and not the hips should support the 
weight of the clothing, and a healthful dress is to be preferred to a 
fashionable one. 

To remedy the evils above referred to, some of the great-hearted, 
large-brained women of our land have invented under-garments 
which shall clothe the whole person from head to foot with an even 
warmth, without bands and without weight at the hips, so that one 
need not feel as though she were comiug apart in the middle. 

The first suit — of merino or flannel or gauze — is a single garment 
extending from throat to wrists and ankles. The chemilette— a 
somewhat similar garment of muslin — comes next The skirts may 
be gored so as to be perfectly plain at the top and buttoned upon 
the chemilette. The emancipation waist which has in a great meas- 
ure supplanted the chemilette, generally meets with favor wherever 
it is examined; probably because, in addition to its being so health- 
ful and convenient, it is pretty and takes the place of a corset with- 
out its hurtful features. It is made high-necked in order that it, and 
all the garments appended to it, may hang from the shoulders. This 
might make it seem warm for summer, but it is not found to be so, 
because it relieves one from the oppressive heat of bands about the 
waist. It is sloped out to fit loosely to the form, comes down over 
the hips, and is furnished with three rows of stout buttons, at 
different intervals below the waist line, which support the lower 
garments and dress skirt. All this applies to undergarments. 

The outer dress should be sufficiently loose and light for comfort 
and health, and simple enough for dignity, but otherwise it may be 
regulated by taste an J the modes of the day. (Mary L. Griffith.) 

MOURNING SUITS. 

The poorest of the poor will wear mourning when a relative dies, 
and the expense thus incurred reduces many families to the direst 
extremity. All of us would do well to remember Hamlet's words as 
to mourning : 



MOURNING SUITS. 159 

" 'Tis not alone my inky cloak, goo 1 mother, 
Nor customary suits of solemn black, 
Nor windy inspiration of fo ! ced breath — 
No, nor the fruitful river of ihe eye, 
Nor the dejected 'haviour of the visage, 
Together with all forms, moods, shows of grief, 
That can denote me truly : these, indeed, seem, 
For they are actions that a man might play ; 
But I have that within which passeth show — 
These but the trappings and the suits of woe." 

Let those, then, endeavor to alter this costly and barbarous fash- 
ion whose example is likely to be followed, and by-and-by poor 
people will think it no want of respect to the memory of their dead 
relatives to go abroad in their every -day clothes. Let us mourn in a 
way that " passeth show," and not in any way which "a man might 
play." The experiment has been tried and found to act admirably 
by the Society of Friends, and society in general would do well to 
follow such a good example. 

The following has lately been circulated : "Funerals should be 
conducted and mourning worn without the dismal paraphernalia of 
hat-bands, scarfs, plumes, heavy crape trimmings and the like, which 
are quite inconsistent with a hopeful belief in a future state, involve 
unprofitable expenditure, inflict severe hardships upon persons of 
limited means and neither mitigate grief nor manifest respect for the 
d>ad." 

In our modern fashion of using flowers on these occasions we have 
lost an old time sweet and charming simplici y and have adopted in- 
stead a sickly sentimentality which finds expression in such stupid 
symbolical and allegorical designs as crosses, lyres, harps, anchors, 
crowns and broken columns made of wire- work and composed of 
white flowers. Imagine Milton apostrophizing his Muse to bring 
him a twenty-dollar crown and anchor, or Hamlet giving an order to 
the undertaker for a hundred dollars worth of allegorical floral de- 



160 HYGIENE. 

signs. Simplicity, whether of the heart or in aesthetics, always indi- 
cates strength and depth of feeling; but the elaborate and costly 
designs of the boquet-makers only indicate depth of pocket on the 
pnrt of the mourners who publish it to the w rid by attaching their 
cards, thus aggravating their bad taste and rendering it disgusting. 

REQUISITES FOR DWELLINGS. 

See that there is free access of air to the front and back and that 
there is nothing to prevent its free circulation. Carefully avoid 
houses built back to back. There should be free ventilation for every 
occupied room, which should have a fireplace and a window opening 
directly on the external air and should not be lighted by a borrowed 
light only. Every window should open both at the top and bottom, 
but especially at the top. 

Have the rooms of good height — nine feet at least in the smallest 
houses if you pos-iWy can. 

There ought to be cross ventilation if possible between the water- 
closet and the rest of the house, and at any rate there should be free 
communication by a window between the closet and the external air, 
and this window should not be too near a bedroom window. 

There should be proper water supply and if it has to be stored in a 
cistern this ought to be arranged for easy inspection and cleansing. 

There should be proper arrangements for the collection, with a 
view to speedy removal, of dry refuse which ought to be kept dry. 
All liquid and solid offensive matters must be speedily got rid of. 
They ought not to soak into and pollute the soil near the dwelling. 
The dry plan, with frequent removal, answers well and it is said that 
typhoid fever is le-s prevalent when this method is well carried out 
than in sewered towns with the water-closet arrangement. The late 
Dr. Parkes, in the little book on public health, written during his last 
illness, says: "At some point between every house and the main 
sewer there should be complete air disconnection, so that any reflux 
of the sewer air may pass into the open air aud not into the house. 



DRAINAGE. 161 

If this were done the spreading of disease by town sewers would he 
impossible. " 

These words contain the pith of sanitary science on the question 
of drainage. 

You should take care that your house is so situaied and so built 
that it may be dry. And beware of those pests of our ]arge towns, 
the balloon-frame house builders, who run up tenements in tie 
suburbs in the slightest po-sible fashion, whose sole aim in building is 
cheapness, and the evasion of every regulation f < r the protection of 
unhappy tenants. 

If the walls are papered see that all previous papers have been 
stripped off. The old papers and the colors and the paste become in 
time hurtful and are apt to breed vermin. You should know, also, 
that many of the pretty cheap papers contain a large quantity of 
arsenic — not the green ones only, as is commonly supposed — but 
those of other colors also. This arsenic is so loosely adherent that 
it is being continually rubbed off as fine dust, and often produces 
great injury. In buying a paper, be careful, then, and do not trust 
too much to the word of the seller, who may know no more about 
it than you do. 

I must add a word in favor of cleanliness, which will greatly aid 
keeping the air of a room pure. Soap and water, beeswax and tur- 
pentine, with plenty of scrubbing, not only made your grandmoth- 
er's furniture, " in the brave days of old," shine like a mirror, but 
was an index of the cleanliness in everything else, which made the 
cottage, as you entered from the honeysuckled porch, seem the abode 
of health and happiness, and of all things sweet and pleasant. — 
(Henry Simpson, M.D.) 

DRAINAGE. 

Dr. J. T. Gardner, in an address before the American public 
Health Association, speaking: upon the subject of the relation be- 
tween topography and health, says : "For a hundred years a con- 
nection between certain topographical features and malarial fevers 



162 



HYGIENE. 




HOUSE WITH EVERY SANITARY ARRANGEMENT FAULTY. 
(after Teale). 

A Water-closet with soil-pipo in middle of house. 
B House drain under floor of room. 

C C C C Waste pipes untrapped, communicating directly with drain. 
O Overflow pipe of cistern turned into soil-pipe and acting as ventilation of drain. 
E Rainwater tank under floor, with overflow nntrapped into drain. 
F Fallpipe communicating with drain opening under bedroom window. 
G Drain under floor with joints unluted, and pipes laid without a fall ; showing 
leakage at every joint, and at the junction of soil-pipe with drain. 



DRAINAGE. 



163 




HOUSE WITH FAULTY SANITARY ARRANGEMENTS AVOIDED. 
{.after Teale). 

A Water-closet with soil-pipe ontside the house, and ventilated by a large pipe 
carried up and away from all windows or chimneys. 
B House drains outside house. 

C O C C Waste pipes trapped, and disconnected from drains by a gully K. 
D Overflow of cistern into open air, or supply pipe. 

JP Fallpipe near bedroom window discharging into a gully, not into the drain. 
G Domestic cistern is separate from water-closet cistern. 



164 



HYGIENE. 




Soil-pipe A imperfectly joined to pipe B pouring all the sewage of the house into 
the soil. Pipe B close to wall of house, and above the kitchen floor. Wall and 
floor damp. C an old surface drain filled with leakage from sewers. 




Soil-pipe A missing dram B and pouring all the sewage into a triangular space 
below the ground floor of the house. 

Soil-pipe C blocked as far as a rise in a drain which, to avoid cutting through the 
rock, was carried by curved tube over the rock. 



DRAINAGE. 165 

has been noticed. Some marshes produce miasma, was the sum of 
past observations; but malaria appeared accompanying such varied 
topography that no law of its production was seen until latterly, 
when character of rock and soil is shown to be as important as con- 
formation of surface in promoting or suppressing malarial fevers, 
and also rheumatism, cholera, diphtheria, pneumonia, consumption, 
and many other of man's worst ills. These diseases appear to be de- 
pendent both upon circulation and excess of soil moisture. The con- 
nection of geological and topographical structure with health will 
then be evident, when it is remembered that natural drainage results 
from combined action of configuration, cliaracter of soil, constitution of 
underlying rock, and tlie form of its surface. These four elements 
regulate natural drainage. Each must present favorable conditions, 
or deadly waters will accumulate on the surface or in hidden strata. 
Hemember, too, that no plan for artificial drainage can be completely 
successful unless based on t a thorough comprehension of the natural 
drainage system of the area under treatment.'" 

SEWAGE AND DRAINAGE. 

We can better describe what is wanted in sewage and drainage by 
describing some of the errors that exist in this matter, by quoting 
at length an article that appeared in the Christian Union : 

" Several years ago, the writer of this article had occasion to find 
a new domicile in one of the favorite suburban resorts of New York 
city people, and finally settled upon a large cottage in a very 
healthy town. This cottage was better ventilated than even wooden 
houses are likely to be, but as pure air always seemed cheap to the 
writer, even though an extra large coal bill was incurred, the cottage 
seemed particularly desirable by reason of the fault alluded to. 
When winter arrived, however, not even loosely framed doors and 
rattling windows admitted enough pure air to ketp the occupants 
awake and bright through the short evenings of a family which 
always retired early. The writer occasionally imagined that he 
detected an unpleasant odor at the register, and some friends to 
whom he mentioned his supposition, suggested dead mice in the 



166 HYGIENE 

pipes which conveyed heat from the furnace to the registers ; 
others suggested that a cast-iron furnace was at the bottom of the 
trouble ; still others (who were promptly withered by a glance at 
the wi iter's better half) suggested a dirty cellar. The writer finally 
found that the cellar was occasionally damp — and he noticed that 
its floor sloped very gradually toward the centre. Putting both 
facts together, lie was not surprised to find a drain, directly under 
tlit furnace, to carry off water ; this drain led to the cesspool, and 
when the furnace was in operation the foul gases of the pool were 
sucked up by the furnace and conveyed through the house. The 
house stood on a good street, was built for occupants with purses of 
reasonable length, and passed as one of the best houses that could 
be hired in the village. 

•' Moving from lhe house to another which had long seemed 
attractive, the writer soon found that unless the cellar windows were 
always open, and a good draught passing through them, a bad smell 
would rind its way into and through the house. An examina- 
tion of the cellar showed that this receptacle was very damp, 
though why it should be was not apparent, for a drain started from 
one corner, and ran to a brook not far away, and at a respectable 
descent. It was finally discovered, however, that the water in the 
well (which was near and in front of the house) was often above the 
bottom of the cellar, and that though the house stood at the bottom 
of a valley, it had no exterior or bottom protection in the shape of 
drains. It was simply impossible to keep the carpets, bedding, 
walls, etc., of this house from feeling damp, even when a steady fire 
burned in the furnace; and the loss of a child was attributed by 
physicians io malarious exhalations from the cellar. The trustees 
of this house were practical plumbers and members of a public 
health association. 

"A handsome high-priced house w T as then purchased from a rich 
an-l reputable citizen, under whose personal supervision it had been 
built. The ground on which it stood was rather low, but a well- 
cemeuted foundation-wall an 1 cellar seemed to defy dampness, 



SEWAGE AND DRAINAGE. 167 

while a system of traps seemed to shut off unwholesome exhalations 
from waste water. After the first heavy fall of rain, however, the 
water from the well was unpleasant to both the palate and nostrils; 
the fault being attributed to the surface drainage, the curbing of the 
well was raised a little. Finally, at the end of a very dry month, 
the taste and odor disappeared, and the last drop of water in the 
well disappeared soon after. Laughing at this feeble attempt of the 
Fates to torment them, the occupants drew upon the well-filled cis- 
tern; here they encountered odors and tastes more repulsive than 
they had found in the well. Fresh cement always makes water 
taste bad, says a practical neighbor, so the ci.-tern was prmptly 
pumped dry and washed out, and the neighbor aforesaid was re- 
warded for his suggestion by having his own well and cistern la ; d 
under contribution unlil the next rainfall. But somehow the 
faculty of that cement for spoiling water was remarkable, and we 
rejoiced when winter storms gave us a full well once more. 

"For six months the cistern was undisturbed, except on washing 
days, although the well occasionally yielded offensive water; at last, 
however, the well failed in the dry season of July, 1876. Once 
more the cistern was approached; the first strokes of the pump 
brought water that was as brown as coffee and as offensive as stable 
drainage. Radical reform measures were immediately resolved 
upon, and a plumber engaged to apply them, with the following 
results: We learned that a cesspool which received all the kitchen 
drainage, including the water in which dirty clothing had been 
washed, was within two feet of the cistern and eight feet of the 
well; the overflow pipe of the cistern communicated with this pool, 
the dimensions of which pool were about two by five feet. The 
kitchen drainage of an ordinary washing day could not with suffi- 
cient rapidity soak into the ground out of so small an enclosure, so it 
flowed into the cistern, while much that went into the ground found 
its way to the well. 

"If the experiences here recorded have befallen the lessee — a man 
with whom good ventilation, perfect drainage, and pure water are hob- 



168 HYGIENE. 

bies — in three short years nnd in houses apparently excellent, what 
must be constantly happening to people who are careless on these 
points, and who consider a house attractive in proportion to the 
smalluess of its rent? How many householders are there, who, un- 
tiring in their efforts for the good and comfort of their families, are 
being steadily and successfully fought by deadly enemies under- 
ground ? How many thousands of the ' sad and mysterious dispen- 
sations of Providence' may be traced to ignorant and unscrupulous 
builders and their employees ? 

"This much the writer has learned by sad experience— to reso- 
lutely trace unpleasant house odors to their source, to discover some 
cause for the evening lassitude which is common in many families, 
and to bringing to the physician for analysis, a sample of drinking 
water which seems in any way objectionable." 

BATHS. 

Bathing of any part of the body is classified by some authors as a 
local bath. The foot-bath is the most common, which is bathing the 
feet in a pail or tub for purposes of cleanliness. Some chamber sets 
include a metal tub which is specially for this purpose. Its use as 
a medical means is alluded to, in the treatment of cold feet. The 
cluxt-lxtik to which we refer in speaking of a preventive against tak- 
ing cold and the diseases of the respiratory organs, is simply bathing 
the body between the waist and neck with a sponge or the hands. 
Oilier local bath-; di.Ter from each o'her only in the part to which 
they are applied. 

Attached to most bath-tubs in cities or in larger villages which are 
supplied with water-work-" and reservoirs, is the showek-batii. 

This is simply the forcible expulsion of water through a perforated 
met al diaphragm. It need not be a luxury confined to the opulent, 
but by a simple contrivance can be introduced into every household. 
A simple plan is to take a common wooden water-pail, boring through 




SHOWER-BATH. 169 

the bottom (a) several large holes — the bot- 
tom could be removed entirely without 
interfering with the process ; it is continued 
in place however to retain the strength of 
the uteusil. Immediately over this should 
be nicely fitted a second bottom (b) of metal 
or wood not perforated. To this should be 
attached a staple and cord. Turning the 
pail bottom upward, a sheet of tin pierced 
with many fine holes (c) should pass over 
the bottom and be fastened to the sides. 
"When the floor has been covered with a 
rubber or oil cloth and the bather is ready, 
the false bottom should be put in place and the pail filled with water. 
The cord should hang over the side. The pail may now be hung 0:1 
a hook fastened in the ceiling. A sudden pull or jerk upon the cord 
will precipitate the shower, which, if the holes are small, will con- 
tinue for some time. This is an excellent bath to follow the Turkish 
or Russian bath, or even the sponge bath, when soap has been used. 
It is very refreshing in warm weather and will reduce temperature 
rapidly. Like all other cold baths, great care should be taken not to 
produce a shock. If the head has been wetted and the bath is first 
received upon the shoulder-blades and back, this may be avoided. 
This is a bath exclusively for the robust and is hazardous if taken by 
the feeble, aged or infirm. 

The warm bath is generally considered the best. It reduces tem- 
perature, but not to a very considerable extent; is more generally 
pleasant, and in most cases agreeable. With soap, it is best adapted 
to remove dirt and all impurities of the surface. If taken in the 
morning, it insures against fatigue for the day's labor, and secures 
cheerfulness of disposition. If taken at night it removes the tension 
of the nerves and worry, and gives refreshing slumber. As a matter 
of cleanliness, such a baih should be taken at lea^t once during each 
week. The cold bath is better relished by the fat, the corpulent and 
8 



170 HYGIENE. 

the vigorous, who possess vitality enough to bring about reaction 
without much effort. All baths should be taken in soft water or 
rain water, and followed by brisk rubbing, with a course towel. 

Turkish and Russian Baths. 

These are of great antiquity. The former originated with the 
Egyptians, by whom it was taught to the Greeks. The Romans 
learned it from them, and afterward it was adopted by the Turks 
and Moors. The latter has been the custom among more northern 
peoples. Both processes may be briefly defined as bathing the body 
in superheated air, the difference between them being simply that 
one is dry and the other moist. The latter is vapor or steam, and is 
to some more agreeable. In either case copious perspiration is pro- 
duced and continued for some length of time. Both are followed by 
shampooing, spraying with water of gradually reducing temperature, 
brisk rubbing, and eventually by the cold plunge or shower. These 
baths have always been considered a luxury, and are of easy access 
to the wealthy, in most of our large cities. With the exercise of a 
little ingenuity, they can be brought with a slight expense to every 
household : Our plan is this : Take a common stool, or a wooden 
bottomed chair from which the back has 
been removed, and into the sides of the 
seat about six or eight inches apart, bore 
holes three-eighths or one-half inch in 
diameter and about an inch in depth. Into 
these place wooden rods of different 
lengths; those at the back (b) shou-d be 
four or six inches in length while those at 
the front (a) may be a foot or two. If you 
have a common hoop, lay it upon them, 
fasten it to the back one and saw off the others t > the outer rim of the 
hoop. This hoop can be fastened in place by cords or pegs, or if no 
hoop is used a stout twine may be tied to one rod and passing 




TURKISH BATH. 



171 




through notches cut in the ends of the other rods be brought back to 
the first and fastened. The object of this skeleton is to keep the 
drapery from the body and 
from the flame. Sitting upon 
this sto 1 with the longest rod 
between the knees, blankets 
arc fastened at the neck and 
pass over the hoop to the 
floors. Over these a quilt or 
two may be laid. If the neck 
is closely enclosed and the 
drapery touches the floor in a 
continuous circle, no air can 
gain admittance. If an at- 
tendant is present an alcohol 
or spirit lamp may be lighted 
and placed upon the floor under 
the stool. If there is no nurse, 
the lamp sh mid be placed before the drapery is arranged In ten min- 
utes free perspiration follows, which may be continued by the robust 
for some time. It is more agreeable to some to place the feet in a pail 
of hot water. and the delicate should have a cloth wrung out of cold 
water, laid upon the head, or the head bathed with cold water during 
the bath. This bath should be followed by bathing in cold water and 
brisk rubbing. There is little danger ff catching cold, and the cold 
water is m >re agreeable than otherwise. Perspiration follows for 
some time and the bather, though dressed, should not expose himself 
to inclement weather until the s rface is dry. 

The gene -al effects of the Turkish bath are described as follows: 
"The results showed that immersion of the body in hot dry air pro- 
due d lo«s of weight to an extent considerably greater than normal, 
amounting, on the average, to the rate of above forty ounces per 
hour. This was accompanied by an increase in the temperature of 
the body and a rise in the pulse r«te, with at first a fall aud then a 



PORTABLE TURKISH BATH. 



172 



HYGIENE. 



rise in the rapidity of respiration. The amount of solids excreted 
by the kidneys wa-? increased, and, coincidently, the amount of 
urea. The sweat contained a quantity of solid matter in solution, 
and, amon^ other things, a considerab'e amount of urea. The m>st 
imporUnt effect of the bath was the stimulation of the emunctory 
action of the skin. By thi* means the tissues could, as it were, be 
washed, by passing w iter through them from within, outward. The 
increased temperature and pulse rate pointed to the necessity of cau- 
tion in the use of the bath when the circulatory system was dis- 
eased." In such cases we prefer the 



Spirit Vapor Bath or Alcoholic-Vapor Sweat. 

This is the Bath fou the Sick. The patient is, of course, in 
bed. and being in a prone position, we never have that fainting to 
which one isexp >sed who sits in a chair and has the dry heat applied 
by contact with heated air. Its application is so simple that we are 
surprised that it is not universally employed. All that is necessary 
is a rubber-bar/, ]u>t water and alcolwl. This bag, 
when not in use, is nearly square and flat, and 
takes up but little space. A handle is attached 
for convenience in filling. A metal screw with 
washers, prevents leakage. To prevent spilling, a 
rubber cup surrounds the mouth. No family 
should bewitlwut the rubber bag; its usefulness 
is manifold. Those troubled with cold feet in 
winter, which prevents sleep, or the sick or aged 
with impaired circulation of blood, arc emphatic 
in its praise. That the touch may be more 
pleasant, we cover it with flannel. To afford 
bubber bag. heat, it is partly filled with boiling water and 
closed. If filled completely, it does not adapt it elf to the part 
in contact. Another advantage is that it holds the heat for 
hours, through the wlwle nif/ht. We will warrant that any one using 
it once will never be without it. 




SPIRIT-VAPOR BATH. 173 

For medical purposes it is filled with hot water as usual, and over 
the flannel is sprinkled or poured a tablespoonful of pure alcohol. It 
is now placed between the feet or knees. The alcohol is driven off 
by the heat and its vapor surrounds the patient. The skin becomes 
flushed, and in a short time gentle perspiration follows. If de- 
sired, this may be continued for hours without inconvenience. It' is 
a most important and efficacious method of overcoming local inflam- 
mation. Congestion of the lungs, pleura, kidneys, uterus, etc., are 
easily and readily overcome. Blood poisons and other' irritative sub- ' 
stances in this vital fluid find exit through the millions of pores on 
the surface. In fevers, of whatever kind, it is an invaluable remedy. 
In scarlet fever we have no dropsy or constitutional prostration fol- 
low when it is used. The kidney troubles especially, which so often 
form grave complications in this disease are m ; ssing, because these 
organs are relieved of congestion and the flow of urine is not dis- 
continued, or the suppression occurs only to a limited extent. " In 
cerebro-spinal meningitis, in inflammation of the bowels, of the kid- 
neys, in those congestive chills which arc so frequent in the south- 
west, it constitutes a most valuable abortive treatment, arresting the 
disease at once. Judiciously and early applied in yellow fever, we 
cannot see why it might not even prevent that immense congestion 
and consequent disorganization of the blood-vessels of the stomach 
and liver, which constitutes the fatal features of its pathology. Keep 
the surface warm and the peripheral blood-vessels turgid, and can 
you have black vomit and softening of the brain? We doubt it." 
In disease more than one bag may be necessary. 

Wet Slieet Pack. This comes nearest to the spirit- vapor bath. 
The amount of diseased matter remaining in the sheet after its oper- 
ation gives but a faint idea of its intrinsic worth. There is not a 
disease, constitutional in its character, but is due, in a great measure, 
to blood impurities — blood-poisoning. The practice among physicians 
of giving emetics, purging drugs and remedies to stimulate the kid- 
neys, is to carry away these impurities. It does so to a limited ex- 
tent. But why forget the skin, the greatest of emunctories? 



174 HYGIENE. 

Spread over the bed a rubber sheet. Over this lay a c tton wad- 
ded quilt, then a blanket or two. Take a coarse cotton sheet, and 
gathering an end into each hand, immerse it in hot water. Withdraw 
it. and alter squeezing it sufficiently to stop dripping, spread over 
the lap bl nket. The person should immediately lie upon the centre 
of this, up <n the baek, so that the top of the sheet is on a li. e with 
the ears. With the arms at the side, quickly draw one side over, 
enclosing carefully every part of the body, fitting it like a glove. 
Then draw thorother side over and wrap the body as perfectly. Fol- 
low with the one blanket and then with the other in the same manner 
and as speedily as careful and proper packing will allow. Particu- 
lar care must be taken that the neck is well enveloped, so that no air 
can be admitted. Over these a cotton quilt may be wrapped. The 
ends of the bl.i nket can then be folded under the feet. If the feet 
are cold, apply a h<>t brick or the rubber bag above mentioned. Great 
stress is laid on the rapidity of the packing in order to | revent the 
cooling of the sheet, and, as a result, the chilling of the patient. All 
uncomfortable feelings dis-ippe-ir, and this is followed by a most 
pleasant soothing sen-ation, and soon after by sleep. 

Compresses. The compress is made of cloth in throe orfonr thick- 
nesses, preferably of flannel, but of any material. A towel folded 
1 ngthwise and then in two is common, and generally most available 
where used for applying heat and cold through the agency of water. 

These take the place of the old fashioned poultice and are much 
more agreeable both to nur^e and patient. They are generally used 
in local pains, such as rheumatism, colic, painful menstruation, neu- 
ralgia, injuries and inflammatory swellings. 

For all the etuis to be accomplished by the compress and for the many 
otlier purposes to which it may be applied, ire greatly prefer the rubber 
bag. These are made of different sizes, but the most useful is about 
a foot square. Even this bag is improved upon by exactly fitting to 
it a flannel cover, which may be sewed up completely, or left open 
at the bottom, with enough material on one side to make a flap 
which may be secured with safety pins or cloth-covered buttons. 



MARRIAGE. 

AN 

ESSAY PBBBBHTOG THE SUBJECT 

HISTORICALLY, PHILOSOPHICALLY 
AND PHYSIOLOGICALLY. 



To be married, perhaps we should say instead, to be mated — is the 
dream of the maid and the ambition of the man. It constitutes the 
ideal of life. It would be ill to have it otherwise. The consideration 
which is bestowed upon the conjugal alliance is an infallible index of a 
people's culture and civilization. In whatever period we scrutinize 
the progress of a race the key is quickly furnished us when we have 
ascertained the footing on which their men and women associate 
There are many phases to this relationship, for the families and tribes 
of mankind have existed in different regions and conditions, to say 
nothing of the varied circumstances of race and type. We have it 
as a sacrament, as a covenant, as a contract, as a, private relation. 
There has been and still continues the subordination of one to the 
other, as the vassal to his baron; and again the law and custom have 
tended to establish a condition of equality. 

To explore ihe ways by which mankind attained such different 
social altitudes would require the investigating of the entire history 
of civilization. It would astonish many who clamor so much about 
modern degeneracy and decry our culture as totally artificial, if they 
should be admitted toa view of the degraded condition from which 

175 



176 MARRIAGE. 

it took its departure. An absolute selfish egotism is the first concep- 
tion that we as individuals have of life; and something like it appears 
to have been the starting-point of the human races when they set out 
upon their career toward our historical and modern periods. Mankind 
have traversed a long way to arrive at our present, exaltation. It has 
often been dreary, thorny, abounding with terrible pitfalls and even 
bloody experiences. It is regarded as a not unbecoming jest to de- 
ride the connubial tie and the honor bestowed upon wives ; but such 
little appreciate the cost at which that honor was purchased and the 
conjugal relation made holy in the estimation of the world. Indeed 
uncounted millions have yet failed to learn this less <n and to attain 
the moral sense accompanying it, which belongs on'y to a high civili- 
zation, as well as to purity of heart and instinct. 

Would any wish the price of our civilization had not been paid 
and that its boon to our generation should be cancelled? 

Would any like to exchange our culture and refinement for the 
condition of any of the peoples that have it not ? A treasure bought 
at so dear a cost ought to be esteemed precious. 

We may be cited to the narrative of Eden as illustrating primitive 
marriage. It may be well to scrutinize the story in order to learn 
whether it constitutes the beginning of our conjugal institution. It 
is recorded there that man was formed first, and inspired with life — 
not merely the power to exist, but the qualities of a living soul. It 
was perceived to be "not good" lhat he should be alone. Woman 
came into existence, and the commentary is made : "A man shall 
1 ave father and mother and cleave to his wife, and they twain shall 
be one flesh." If this sentence has any specific meaning, it is a direct 
assertion of female supremacy. A man abandons and abjures all 
relations to his own kindred and merges his lot into that of his wife. 
The two are thus as one person, which the woman represents. When 
therefore, the serpent in the garden asked to know the obligations 
which had been established, he addressed her. This was not because 
she was the weaker and easier of approach, but because she was the 
superior. She observed the Tree of Knowledge, she plucked the 



MARRIAGE. 177 

fruit, and, in company with her husband, ate it. The penalty in- 
flicted upon her was degradation — subjection to the man. " He shall 
rule over thee." 

The more primitive races of human kind regarded the mother as the 
head of the family. From her the children were named, and by her 
and her kindred they were reared and directed. Traditions of this 
primal order are found in different parts of Asia. Religion took its 
moulding from it, and the Great Mother became the object of wor- 
ship everywhere. " Ma," the first word learned by infants, was the 
very designation bestowed on the chief deity in Asia Minor; and the 
Papa, or Atys, was her protege and subordinate. The aboriginal 
tribes of America to this day reckon their families and clans by their 
women and never by male parents. 

War seems to have changed the condition of society. As violence 
became general, the men associated as fraternities to resist it, or to 
subject others. Women, cumbere I with the duties of maternity, 
were in poor attitude to fight. Their love bound them to their hus- 
bands, and these in turn became their lords. So long as war is a 
principal object of social compact, and the sword is the arbiter of 
dispute, the condition of woman will be subjection and vassalage. In 
useful labor, they are equals ; in the capacity for endurance, superiors. 
When these qualities become highest esteemed inhuman civilization, 
women will become equal in the home. 

Religion has in time sanctioned the present order. Itself the out- 
birth of human aspirations for spiritual life, it always takes the form 
given it by the people who possess it. In the language of the Prayer- 
Book, woman, when assuming the conjugal obligation, promises to 
love, honor and obey. Why? Because no longer does "man for- 
sake father and mother." The woman now is the one required to 
" forget her own people and her father's house" to become as the 
dau liter of her husband, of whom the Psalmist assures her, "he 
is thy lord." (Ps. xlv.) 

The formula, the customs, and the requirements of marriage, have 
thus crystallized the whole history of the new departure, even what 
8* 



178 MARRIAGE. 

we are now steadily outgrowing. Conjugal pledges of obedience are 
daily ceasing lo constitute the law, and women freely demand equal- 
it} - , and refuse passive submission. 

It seems to have been with reluctance that the legislation for fe- 
male vassalage was accepted. . The entire power of the pii< stbood 
was requin d to effect the result. In Rome and Greece, the nobles 
ad patricians received their wives with religious rites. The lathers 
divorced their daughters at the family altar or hearth, and alienated 
them from the paternal household. They then gave them into the 
hands of the bridegrooms, who conducted them to their new al;od< s. 
Here, lifting them over the threshhokl, they were conducted to the 
hearth-stone and adopted or initiated into the fami'y of their hus- 
bands. The same rights of life and death, of personal service, were 
now the husbands', as they liad before been the fathers'. Such were 
nuptials and marriage sacraments. Their violation was sacrilege. 

But all were not so married. No priest entered the house of a ple- 
beian. His children had only permitted rights. They seem to have 
adhered to the older customs. By law a woman, like any other chat- 
tel or movi able, became the absolute property of her husband by vir- 
tue of a year's undisturbed use and possession. Women, by remain- 
ing away three nights in the year, prevented this merging, and re- 
t ined personal freedom. It was done in Rome by observing the 
feast of the Mother, or Bona Dea. 2so man under the penalty of 
sacrilege might intrude there. In Greece, the Thesmophoria, the 
boon reserved for her daughters by Demeter or Ceres the Lawgiver, 
afforded them the requisite liberty. The Egyptian women also had 
a like observance; and if we read the Bible aright, the Israelitisb 
women nlso had their practice of assembling by themselves in multi- 
tudes, for the fast. The sons of Eli are said to have taken advan- 
tage of this, and were accordingly deposed from the priestly 
supremacy. 

In these usages the sanctity of the Mother had its inception. In the 
quarrels between clans and tribes, the women had husbands in one 
party and brothers in the other ; and so were sacred alike on both 



MARRIAGE. 179 

sides. They escaped destruction from massacre, and were often en- 
abled, as in the case of the Sabine woman, to mediate for peace. Re- 
ligion carried the matter still further. The Germans held that women 
possessed a divine spirit, and so made them the favorite oracles and 
interpreters of the will of the gods. Unlucky was this distinction in 
modern times, wheu the pagau worship was denounced as commerce 
with the infernal powers; and its ministers denominated "witches." 
The broom of Thor became their curse as it had been their badge. 
When the mother of a clan lived no longer, her spirit was believed to 
watch over her posterity, and she was worshipped as the Lady of her 
People. In this capacity, doubtless, Demeter as Goddess-Mother,, 
provided for her daughters by the Thesmophorian law and festival. 
Whatever its nature, it preserved what of freedom the women of 
Greece enjoyed. 

It may be well for those who decry our culture as almost wholly 
artificial, to bear in mind that it has established conditions of vital 
importance to human welfare. The average length of life has more 
than doubled. The earth supports a larger population. Famine is 
of less frequ'nt occurrence and pestilence less deadly. Women have 
been rescued from social vassalage. From being the chief menials 
of the household, the prizes of adventurers, purchases for harems, 
they become the companions of their husbands, queens of the draw- 
ing-room and social circle, esteemed, honored and treated in every 
way according to the position they sustain. Instead of a servile and 
degraded condition, they have attained the honor and dignity of 
wifehood. Once maternity constituted their chief claim to respect, 
but now it is the fact, the rank, the distinction of wife. 

It is one of the glories of our English tongue that its vocabulary 
furnishes words to express this great human advancement. Few 
other languages enable this. In most dialects womanhood has no 
distinctive appellation to express social condition. It only denotes 
an adult of the female sex. But the English- speaking people made 
their words mean discrimination; so that the wife should be recog- 
nized in her queenly rank in every household. Nor did they stop 



180 MARRIAGE. 

■with that. They likewise ordained that every such household should 
be made a home. Philologists may show that these distinctions 
are not sanctioned by laws of derivation ; but the nobler sense of 
men has triumphed, first creating a relation between woman and 
man which did not elsewhere exist, and fixing the meaning of words 
to express it. Whatever Latin, German or Sanskrit may import, the 
English language and our institutions recognize the home as the 
abode of a nuptial pair, at once a dwelling and a shrine; the wife as 
the princess-regent, the priestess, and the revered one ; the man as 
the husband, the band of the household, holding together the sacred 
fascicle of home-sanctities and domestic relations. 

The intrinsic sanctity thus hallows the relationship, and makes 
it sacred and enduring. Its permanency is founded in its purity, its 
unselfishness, its influence to perfect men and women as divine, 
rather than as mere human beings. Willingly may we concede to 
the dreary past of human experience all the honor it merits for this 
sequel to its career. However vile and unworthy the incentive 
which first led men and women to seek each others' society, it has 
in the long tragedy of ages brought a higher ideal into their con- 
templation, and produced a social rtlation where every aim of each 
is addressed to enhancing and maturing the happiness of the con- 
sort. Rendering t> the ancient institution all that belongs to 
it, we propose also to '" render to God the things that are 
God's.'' It is not enough for us in the present stage of hu- 
man evolution, thai "twain shall be one flesh." The higher ideal 
is to be " one spirit," one mind, one thought, one will. Toward this 
point every romantic lover eagerly h oks; and it is the focus of 
aspiration with every properly-associated man and woman. In such 
a relation the responsibilities of marriage are forgotten in its sancti- 
ties We are transported to the highest motive of human action, 
Love — the regarding of another's welfare rather than one's own. 
It is the function of love to develop freedom ; and marriage to be 
true, genuine and divine, must be the evolution of the purest love 
au.l the moit perfect freedom. That this is the concept which be- 



MARRIAGE. 181 

longs to the relation is evinced by the comparisons, so often made, 
that the Maker of the Universe is the husband of his creation. 

In the relations of life, the task is set us to contemplate the high- 
est ideal, reconcile with it as we best are able, our every day experi- 
ence. The higher our moral culture and development, the more 
certain this is to be done; and yet the association of man and woman 
is the first, perhaps the chief means of such culture. We must take 
the matter as we find it and endeavor with all our will to render it 
what it should be. 

"Every promise of the soul," says Emerson, " has innumerable 
fulfilments ; each of its joys ripens into a new want. Nature, un- 
containable, flowing, forelooking, in the first sentiment of kindness, 
anticipates already a benevolence which bhall lose all particular re- 
gards in its general light. The introduction to this felicity is in a 
private and tender relation of one to one, which is the enchantment 
of human life ; which, like a certain divine rage and enthusiasm, 
seizes on a man at one period, and works a revolution in his mind 
and body ; unites him to his race, pledges him to the domestic and 
civic relations, carries him into new sympathy with nature, enhances 
the power of the senses, opens the imagination, acids to his character 
heroic and sacred attributes, establishes marriage, and gives perma- 
nence to human society." 

The life of the cdibate falls short of this ideal. It is opposed to 
the design of nature, that lias implanted passion in every one as 
strong, almost, as life its- If. Social conditions, philosophic or 
religious enthusiasm, may bar against forming connubial relations ; 
but it is always attended by the vivid sense of incompleteness and 
dis;ippointed aims of life, even if no vigilant Nemesis appears to 
chastise the unfortunate. Yet better is celibacy, better all the pov- 
erty of soul so often accompanying it, better even the \ hysical suf- 
fering that it may oce: sion, than false, loveless, unhappy marriage. 
It may have been onee different, when mankind were savage and 
uncultured, with little spiritual aspiration or development. The 
same laws and considerations would then control which govern the 



182 MARRIAGE. 

whole world of animals. It is of little account to attempt to elevate 
individuals above the general level of their spiritual condition. But 
human nature and human thoughts are slowly ascending to a higher 
altitude. Though men and women are not quite angels, but retain 
every characteristic and incentive which has ever imbruttd our spe- 
cies, there has come into form and activity a seutiment of love, a 
spiritual conception, which transcends, while also it blends with and 
elevates the physical impulse and instinct. We, therefore, may 
aspire not to abolish social relations between the sexes, but to raise 
them higher toward divinity. We will honor and esteem them for 
what they have accomplished, rather than scorn their short-comings. 
If men and women had been what they were designed in the crea- 
tive idea, these would not have been. But the ideal of conjugal life 
has been exalted till it has become capable of adding a hundred-fold 
to human happiness. It is looked to by the youth and the maid as 
never in former tim'-s; not as the mere cementing of family alli- 
ances, but as affording to the individuals themselves the fruition of 
their dearest hopes. 

Our libraries are full of the literature of this human love. Only 
select ones peruse books on science, and a very few read treatises on 
philosophy. But the novel, gushing and overflowing with passion, 
is eagerly sough'. The manifestation of affection between a man 
and woman attracts quick attention, and theucefnrih we are conscious 
that they and we are no more strangers to each other. We have 
witnessed that "touch of nature that makes the world of kin." It 
may lie, it too sadly is true, that such is the sentiment as it appears 
in hope rather than in history. There has been a disappointment in 
experience; the actual too generally fails to fulfil the ideal. "Grief 
clings to names and persons, and the partial interests of to-day and 
yesterday." 

With all this, love is, nevertheless, the ladder of the soul. It 
Ftand3 on the earth, and its base is imbedded in the soil. But its top 
is in the heavens, and the angels of God are ascending and descend- 
ing upon it. It fills the heart with revolt against common prudential 



MARRIAGE. 183 

considerations. The education of young women that mariiage is 
only the thrift of a housewife and that" woman's liie has no other 
aim, is witheiing to the hope and ; ffeciion of human nature. Time, 
to be sure, solves passion, and the offices of life to which men and 
women are severally appointed, h quire each to live much apart from 
the society of tho other. Instead of living in each other's society, 
they must learn to live in each other's interior life. The charms of 
pers >n, once so captivating and engrossing, j a>s -away like the blos- 
som of the spring, leaving the man and woman to be allied by the 
intellect and heart. This is the real marriage which the former only 
typified and foreshadowed. 

Marriage now becomes a study. To be a husband or a wife is a 
world more than the pries: ly benediction has foreshadowed. It is 
the business of a lifetime as the prelude t> an eternal existence. 
Its rewards are in the delights and perfections whi<gi are incident to 
maturity; the penalties are the griefs and discontents that attach 
themselves for indefinite periods to the spirit, and will not disappear 
at command. 

There cannot be too much or too careful consideration of the mat- 
ter. The motives should be scrnl inized with the strictest conscientious- 
ness The legal view is, however, too gro^s and repulsive to a mind 
that has been duly refined. The first obligation of the husband is to 
his wife and of the wife to her husband. The basis of the obliga- 
tion is not the nuptial contract itself, but conjugal love which that 
contract should be infr nded in good faith to express. The sexual 
impulse which nature has implanted in every healthy and perfect hu- 
man being, is not sufficient of itself to consecrate a connubial alli- 
ance. Its office is to suggest such a union, but not to lead the way. 
The possession of reason, social affections, and spiritual aspirations, 
is evidence that they are to direct in every arrangement which in- 
volves the well-being of a life. Love is not passion, but a principle 
of being, not merely essential to the happiness of life but to the ac- 
tual life itself. It is the great departure from selfishness and all those 
ideas and considerations that revolve round the selfhood as their 



184 MARRIAGE. 

common centre. It is the union of one life to another by that law of 
polarity which attaches indissolubly the most distinct and opposite 
natures. There is no lowering of the tone, the character, the hu- 
manity, but their exaltation to a higher moral and spiritual plane. 
There is no real surrender or curtailing oi freedom, but a directing of 
it in its legitimate channel. 

Much has been written ably and eloquently of the duty of conju- 
gal partners to each other. We should not bate a straw in regard to 
the love, the amenities, the mutual kind offices incident and neces- 
sary to the relation. But the propriety of much of the counsel that 
is given implies more or less that a marriage of convenience exists, 
rather than a real conjugal alliance. It is more than possible, we re- 
gret to acknowledge, that this is true. The earlier marriages which 
many encourage are more or less the unions of boys and girls, liable 
as they mature to grow apart and to drop off whatever of mutual 
affection they have ever had. Besides a pernicious education has 
been disseminated, by which marriage is made a woman's profession 
rather than a condition of interior election and choice. It is not re- 
garded as very essential that she loves, or even prefers the man she 
marries; but rather th it like the merchant having wares to dispose 
of, seeks in every market for his most e'igible opportunity, her suc- 
cess is to achieve a bargain ; she fails, if she does not ; she will suc- 
ceed in proponion to the brilliancy of the match ; but an indifferent 
partner is better ihan none. Ouce married, the world is lived with 
as best may bj done, Self-indulgence comes in first of a'l. The 
fortune of the husband is regarded as in a feeble degree his own; his 
wife has superior claim to possess and squander it. The principal 
bankruptcies, the most atrocious delinquencies that have disgraced 
American history, are due to this besetting sin of American wives. 
Having no intrinsic n oral character, having sold themselves for hus- 
bands, they set foot like courtesans on the fortun- s of the men, and 
scruple little at the hitter's inculpation in crime, if it only obtains 
money for them to squander. 

Too generally, in modern civilizatio •, marriage is thus contracted, 



MARRIAGE. 



185 



and exists without sanctities. Homes in such circles are obsolete. 
Men are coarse in taste, self-indulgent and faulty, but all these de- 
fects of character are confirmed by women denominated wives, who 
are interiorly false to the ideal of the name. 

In all such spurious alliances, there is no place for children. 
Naturally enough, legitimately almost, they are not desired. For- 
tunately often, the unphysiological life incident to fashionable 
society early unwomans the married,* and incapacitates them for 
the producing of offspring. When this end is not effected, the 
skill of the family physician does the desired work. We say little 
of the professional persons whose unhallowed vocation is a feature 
of our peculiar civilization. They are the lesser culprits, and like 
blotches serve to reveal a deeper taint. In such marriage alliances 
as these, it is not an indisputable question, whether their unfruitful- 
ness is not fortunate rather than an evil. The laws of nature arrest 
the perpetration of hybrid races, either by utterly destroying the 
power of fecundity, or the early extinction of the progeny. The 
children of drunkards and libertines are often extinct after the third 
or fourth generation. The immixture of wholesomer blood some- 
times arrests this total destruction ; but often with a taint perpetu- 
ated, as in the case of the myriads of scrofulous families in 
Europe from the syphilitic ancestry of the fifteenth century. The 
Black Death, itself the product of unconjugal living, has done rare 
service in weeding out these slips of noxious growth. It often 
seems, therefore, as if it would have been better that they had not 
existed. 

We are willing to surrender the whole question of parentage to 
those who are charged with its duties, cares and responsibilities. 
The instinct is deeply and ineradicably implanted in our nature. 
The best-blooded, most perfect in heart and intellect, seem to possess 
it the strongest. Having their affections disciplined from self- 
seeking to generous love, they are best endowed and most disposed 
to rear offspring. The unloving are most willing to forego them. 

When privation interferes to obstruct proper rearing, it is often 



186 MARRIAGE. 

expedient to postpone or omit having them. Our civilization, the 
wants of our race, all protest against the production of an impover- 
i-hed generation. An ill-born cbild owes no reverence to those who 
br. ught him into existence. This consciousness, transcending con- 
viction, ha. already resulted in a very general subversion of cour- 
teous manners, and respect of the young for the older in families. 

The fault, the error, may be and generally is in the false character 
of the nuptial tie j nevertheless custom and expediency generally 
agree that this falsity should not be amended, but rather its conse- 
quences endured. It certainly operates to make the birth of child- 
ren undesirable. Moralizing can go but little way to mend the 
matter. As the appetite for food is so inwrought into every fibre 
eel' and molecule of our bodies, that we will devour the most un- 
wholesome substances and risk every peril, to satisfy it, so too is 
the passion of sex. If partners, that will make better every incen- 
tive, and desire cannot be procured, mankind unwilling to forego 
and often conscious of exquisite misery from forced abstention 
will e - counter every risk, moral and mortal, because nature has 
implanted the disposition, strong as the life itself. But ill ben-innino- 
is not the way to a good ending. 

It is no requirement of nature or morality that every sexual union 
should be prolific. The object of the act is higher than that. Its 
foremost purpose is to render the individuals more loving more af- 
fectionate, more disposed to contribute unselfishly to each other's 
happiness. However unlike all this the primary impulses may 
seem, the. tendency if not checked is to this culmination. Animals 
have no moral character, or capability for spiritual growth, and 
hence their matings and pairings go little beyond the immediate 
impulse and the passion for possessing. But even then, few compar- 
atively of the sexual unions are prolific. Many offspring engen- 
dered never come to the birth, but are aborted. Many that are born 
perish soon afterward. In the vegetable world, not one seed in amil- 
l.o , ev r vegetates. The residue are at hand for the purpose, if wanted, 
but the earth has no space, for them. Sometimes animals have the 



MARRIAGE. 187 

instinct to arrest their own overproduction. The bees annul the sexual 
function for their own race. So do the ants, the squirrels and 
others. It may be supposed to be equally lawful for human beings ; 
only we plead for the action of an intelligent conscience, and not the 
exercise merely of a despicable selfishness. 

But taking things as they are, it is certain that we cannot have 
them altogether as they should be. The ideal is for us to approach; 
but every-day facts must inevitably have the paramount control. We 
cannot counsel celibacy; prostitution is its certain accompaniment. 
The appetites natural to us are laws which will instigate to action. 
Whatever cases may exist exceptionally, are neither sufficiently nor- 
mal nor numerous to wan ant us in modifying this statement. Some 
have questioned even whether enforced monogamy did not occasion 
prostitution. It is wisdom to say: Let every man have his wife and 
every woman her husband. The first duty of every conjugal part- 
ner is to the companion. This does not warrant, however, any 
sacrifice of personal comfort or propriety to the other's wantonness. 
What is not lovingly desired, there is no moral obligation to bestow. 
It is every man's, every woman's duty, to preserve health, purity and 
integrity of body and character. No marriage obligation may con- 
travene that. It is well for persons assuming the relation to bear 
these facts in mind at the outset. The institution is primarily 
designed >o promote their happiness, and thereby their usefulness. 
It gives the opportunity to have offspring, under more favorable 
conditions; but does not justify them in so doing except their uses 
in this world are promoted and their happiness accordingly en- 
hanced. It is more than unfortunate for parents to have children in 
disproportion to their ability to provide for them comfortably. 
Fathers and mothers, made wretched, sick and nervous from over- 
work and privation, and often hurried to death prematurely, cannot 
render a parent's office, and had no business to assume it. 

Another moral evil in households is the fact that the introduction 
of children into the household weakens the love of the father and 
mother for each other. They have less regard for each other's com- 



188 MARRIAGE. 

fort; and when it is considered it is viewed as a duty rather thin a 
spontaneous evolution. The birth and rearing of children superim- 
poses new duties upon the parents; but should not root out the old 
affections. Numerous are the men who are crowded from their seat 
at home by their children. Too numerous are the women who find 
the society of their children having charms superior to that of their 
husbands. Even the animals surpass this. They pair and make an 
abode together, they unite in caring for their offspring, and return 
to their old relations when these have matured. If the long child- 
hood of the human race precludes this to a great degree, the conju- 
gal bond should transcend the parental in vigor and enduringness. 

Marriage should be more delightful, sweeter, purer, than courtship. 
It should witness, not a mere display of attractive graces put on to 
captivate, but the development of all the choicer qualities of personal 
character. A man who is not careful, attentive and respectful to his 
wife, and a woman that is not pleasant, kind and regardful to her 
husband, annihilate whatever of sanctity their relation may have 
possessed. Marriage cultivates and expresses more perfectly every 
courtesy of social life. 

Hasty and thoughtless parentage is no better than hasty marriage. 
The better way is to leave the decision with the mother. She has the 
peril to life and health to encounter, the burden and suffering. 
Often she has disinclination at one time, which does not exist at 
another. Dr. Jackson has remarked very forcibly: "If she con- 
ceives when she is disinclined, or finds herself in a family-way when 
she does not want to be, the disaffection and moral disgust which 
will arise, and which she will carry all through the ante-natal condi- 
tion of her child's existence, will stamp its character more deplorably 
than any birth-mark could its body. No woman can be unhappy 
during pregnancy without carrying over as constitutional qualities 
in her child's organization the causes of her unhappiness. There is 
not a case in ten thousand where this view does not turn out to 
be true. If a woman conceives a child at the time she is in less 
than ordinary affectionate relations to her husband, or to others; if 



MARRIAGE. 189 

these relations continue for any length of time after the conception 
has taken place; her child will never love its father nor be a man of 
public spirit. * * * Child-begetting and bearing is not a play- 
spell. It is the organization of new life, and very grave considera- 
tions attach to it. Whenever a woman is to bear a child, her sur- 
roundings of exterior life, as well as her interiorly vital and worship- 
ful relations should be made as nearly perfect as possible. Then she 
will give a moral, mental and spiritual organization to her offspring 
that will make his coming into the world a blessing." 

Marriage is an educator. It therefore should not be ruptured for 
slight reasons. The mutual fondness that brings people together is 
often the result of a social longing, without any special evoking of 
interior principles. It is very liable to wear out, and a wearying of 
one another to result. If sexual wants were not so much consider- 
ed, but social needs more carefully studied, there would be a bet- 
ter beginning. If after this, the purpose be formed to be and 
become, what each should be, the apparent mistake may be trans- 
formed into another of the numerous examples of building wiser than 
they knew. Let courtesy and an obliging disposition be assiduously 
cultivated; each, foregoing whatever of disappointment may have 
been experienced, resolve to render the kindest regard to the other. 
Let every one beginning conjugal life, hold back from such sensual 
indulgence and strive to complete their unfinished courtship. The 
real pleasure of the nuptial relation is found in the social and intel- 
lectual communion. Where these fail,the person is poor, for they fail 
to provoke the highest love of which human beings are capable, and 
perfect every thing that is lacking. The most exquisite enjoyment 
a married pair ever found is in the intercommunication of thoughts. 
In this there is always zest, never satiety, nor weariness, nor a feel- 
ing as if it was desirable never to have a repetition. 

In the primitive conditions of human society, men and women as- 
sociated as brute animals; each living for self and little regarding the 
other. The mothers had and owned the children. Yet from the lit- 
tle altruism, or regard for another, thus engendered, came a broader 



190 MARRIAGE. 

feeling that others had rights which must be respected. The conju- 
gal love was in time extended to an affection for kindr< d; thin into a 
fraternity and tribe. All the while humanity was widening in. the 
scope of affection, and with it came culture. Religion underwent a 
like evolution. When men died, it was believed that their spirits 
remained alive, and attended upon their children and kindred. It 
was usual to seek to propitiate them with offerings. In this way 
came the worship of ancestors, and the sacrifices of the dead. The 
same altruistic feeling that had learned to respect the rights of others 
was carried to the other world. The spirits of the dead became the 
over-lords of the living, their family-gods, their divinities. In time 
the father-god of the clan became the god of the people. The woman 
who entered the family as a w T ife, became the subject of its gods, 
and no more had protection from those of her own people and 
father's household. Then love to the neighbor became the idea of 
the world-religion, and one God the Father of all mankind. This is 
the last ideal of human excellence. It takes from none any of the 
instinct of self-preservation, but leaves tie primitive nature intact. 
But it has taken the love of sex, expanded it to the love of kindred, 
veneration for spiritual beings, national patriotism, clear to univer : 
sal benevolence, and the love and worship of one sole Divinity from 
whom every human spirit is an emanation. 

Aristotle proclaimed the supremacy of the idea that social order is 
founded on love rather than on justice, and that Eternal Justice is 
love. This is the source of the grand sentiment of human brother- 
hood. Jesus taught little supernaturalism ; but the doctrines im- 
puted to him, that of a holy spirit which shall awaken in all an en- 
thusiasm of humanity, by enabling man to perceive the simple but 
mighty truth that love is morally omnipotent. This divine spirit in 
mankind supplied no new principle, but was only the evolving of 
what was already present. Jesus taught that man is naturally capa- 
ble of the sentiment, not only to produce a life of holiness subjec- 
tively, but also to overflow in a tender compassionateness towards 
others. In so far as Christianity is superior to other religions, it con- 



MARRIAGE. 191 

sists in the fact that it founds its highest morality on this basis of 
love. It was not possible till the age in which it appeared; a;;d then 
only from the discipline which men had undergone in the previous 
ages. The practice of benevolence which it enjoins, meets a response 
in every mind; the feeling from which it springs increasing in 
strength from generation to generation, till the observance of the 
active virtues are regarded as the duty of every man. 

The author of Ecee Homohas summed up all the Christian idea in this 
one expression: <l humanity changed from a restraint to a motive." 
That which is right, as soon as it is ascertained, is binding on the 
conscience. It must be discovered simply by reference to the experi- 
ences of humanity, and the laws that govern its moral develop- 
ment The instincts innate in every one, as has been already as- 
serted and shown, form the essential foundation of all morality. The 
chief concern with every individual is the perfect development of the 
powers and faculties of his own being; the primary motive to right 
action is duty to one's own being as man. So far virtue is passive 
and negative. The active virtues are based on duty to others as com- 
mon members of the human brotherhood. Both, however, have their 
common basis in the nature of man as derived from a divine origi- 
nal ; and therefore it must be traced to the Infinite or Universal Exist- 
ence of which mankind forms part. The sanction for both the active 
and passive virtues is to be found in man's duty to himself as a child 
of God, and moral obligation may therefore be placed on the deeper 
basis of duty to God himself. The requirement is to live in strict 
accordance with the principles of man's nature ; and as this is de- 
rived from God, his being may be said to supply the real test of 
moral conduct. Perfect harmony with God is only possible when 
perfect purity has been attained — when the Divine nature of a man 
has been perfectly developed so far as this is possible under the lim- 
iting conditions of the human organism. The human soul thus 
attains the highest degree of internal illumination of which it is capa- 
ble, accompanied by the complete performance of all the moral obli- 
gations which the laws of its nature lequires. 



193 MARRIAGE. 

This is the culmination of the marriage idea; as the nuptial pair 
become more as one they develop more and more of the personal and 
altruistic virtues that indicate the divine nature and influence; the 
perfection of which is the highest degree of spiritual illumination, 
and a perpetual union with Divinity Itself. 



MEDICAL PRACTICE. 

AN 

INTBODUCTOBY CHAPTER. 



" The knowledge which people possess of the art of healing is the meas- 
ure of their refinement and civilization. " 

The human system is like a delicate complicated piece of beauti- 
ful machinery, calculated in a state of perfection to perform its varied 
operations with a precision and regularity not surpassed by any 
known mechanism. It is liable to become disarranged, obstructed 
in the actual performance of its functions; and then, instead of crea- 
ting greater disturbance ; instead of resorting to measures which 
would produce greater hindrances, which would retard or destroy 
any portion of the organism; how much better to use only those 
agents which would clear out whatever was in the way of its harmo- 
nious action, and leave it in its pristine condition unimpaired. 

It is not philosophy, it is not science, it is not morality, it is not 
common sense, to use agents that aggravate an already diseased and 
irritated constitution, instead of those that relieve and quiet; nor to 
employ measures that endanger and destroy life, instead of those 
that conserve and save it. 

When we review the statements made by the most eminent phy- 
sicians that, in effect, the practice of medicine, as it has been prac- 
ticed heretofore, is a curse instead of ablessing; that ithas " destroyed 
more than famine, pestilence, or the sword;" that " eighty or ninety 



194 MEDICAL PRACTICE 

per cent, of those who employ phys-icians are better off without 
them;" that their practice " f osti rs disease more than it cures it;" 
that it "debases and ruins the constitution;" when we see ihe evi- 
dences ourselves in the devastations produced, the wrecks of our 
fellow-beings n round us, no one will for a moment question the immi- 
nent necessity that exists for the abandonment of such a base 
treatment of mankind, under the pretext of trying to benefit them 
and the substitution of a mode at once more rational, scientific and 
human. 

PRACTTTIONETIS. 

The different schools of medicine in their teachings upon the sub- 
jects of Anatomy, Physiology, Pathology, Chemistry, Obstetrics, 
Surgery and Materia Medica, substamially agree. They differ, to 
some extent, upon the theory of disease, but very widely upon the 
practice of medicine. The former is comparatively unimportant. 
The unprofessional soon learns that certain diseases are contagious in 
their character and shuns both the person and the place afflicted. Of 
the highest importance to mankind is the means to be employed in 
eradicating the disease. When a person is afflicted, it is too late to 
think of theor}'. His prayer is for relief and cure. We do not 
mean to undervalue the labor of scientists, for we heartily accord th» m 
their full measure of merit and praise, but the history of medicine is 
a continuous diatribe upon theories which are accredited to-day and 
to-morrow discredited, if not ridiculed. We believe from all this 
great truths have been sifted and culled out, and that steadily the 
profession is advaneing. But man, well and properly born, should 
survive his allotted time of three-score and ten years. The machinery 
should then cease because it has worn out. Contemplating this fact, 
how startling are the mortality reports ? Surely the percentage 
should be considerably lessened. We believe that the majority of 
practitioners of the present day are liberally mindt d and would not 
hesitate to adopt any means that would alleviate suffering, diminish 
disease, and prolong life. This is eclecticism in its true sense, and 



ITS DIFFERENT SCHOOLS. 



195 



" choose the best " does anything but circumscribe the field within 
the limits of one school of medicine. The difficulty lies in the fact 
that our colleges and professional brethren teach school and sect too 
much, and not to the proper extent, the science of medicine. The 
Old School are wealthy in their knowledge and literature. They far 
outstrip all rivals in their contributions to the different departments 
above indicated. The most bigoted will admit, at least, the possi- 
bility of there being some truth in homoeopathy, or he might be con- 
siderably perplexed to satisfactorily explain their extensive and 
attrahent practice among the wealthy and intelligent classes in all 
civilized countries. Another school which is gradually gaining 
strength in this country is known by the title Eclectic. Like the 
others, however, they are sectarian and have bounds beyond which 
their votaries shall not trespass. Who will not admit that they have 
done much to advance medical science, particularly in their favorite 
field, the discovery of the medicinal virtues of the indigenous plants 
of this country ? There is scarcely a physician's shelf or drug-store 
in the United States that does not contain many of their remedies. 
Hydropathy has given the world many valuable facts respecting 
the treatment of disease, and has si far simplified practice as to 
bring its valuable methods within the reach of any intelligent house- 
hold; but sectarianism rules here also, and, instead of seeking some 
medicine that may assuage pain, heal a wound, or cure a disease, they 
disbelieve wholly in the use of drugs and change treatment only in 
so far as to discover if some other and untried use of ica'er will not 
exactly suit the purpose. We know of one case in which a lady 
patient was washed (externally and internally) to death. 



its mysteries. 
Under the uncertain and fanciful theories which have been 
advanced to explain disease, is it any wonder that there should be 
mysteries, contradictions and absurdities in the practice of medi- 
cine ? If mystery is connected with the nature of disease, mystery 
will also be associated with the practice of medicine. Quacks and 



196 MEDICAL PRACTICE. 

charlatans -will flourish on this mystery. The people are ignorant, 
and therefore liable to be duped by every boastful pretender. The 
greater the bombast of the pretender, the more will he impose upon 
the credulous. If he have cunning and shrewdness, he is almost 
certain to amass wealth. Many honorable people knowing the 
cheat, come to the conclusion that the people love to be humbugged. 
Some, otherwise honorable physicians, seeing the success of quack- 
cry, and having a desire for the spoils, turn in and practice the 
same black arts. Others, truly honorable, utter their earnest pro- 
test, but it is of no avail. They ought not to complain. They are 
themselves mostly responsible for this state of things. The mysteiy 
thrown about disease and also the practice of medicine, by the 
medical fraternity, is the legitimate cause of this quackery. If dis- 
ease be a mystery, th( n the practice of medicine is an enigma. The 
more profound this mystery, the more doubtful and perplexing is 
medical science. If our popular physicians were uniformly success- 
ful in practice, they might enjoy an enviable reputation. But the 
great uncertainty that attends their prescriptions has seriously im- 
paired the confidence of the people in their skill, and in their dis- 
traction they fly to any source which promises the blessings they 
seek at the hands of medical men. If they obtain the blessing of 
health from men of humble pretentions, it w r ould be strange if they 
did not ever after favor those from whom they received such timely 
aid. The practice of medicine must, then, be divested of its mys- 
teries, if we expect harmony among its members, or honor to be 
awarded to this noble profession. 

KNOWLEDGE NECESSARY. 

Many of the grievous ills which mark our course through life 
must be ascribed to defective education, to deteriorating circum- 
stance', and to w r ant of determination on the part of parents 
to maintain a restrictive government over themselves and their 
children. 

The starting point toward the alleviation of physical suffering, is 



POPULAR KNOWLEDGE. 197 

a close study of the laws which govern our organization, for if these 
laws are violated we cannot hope for a continuance of good health. 
Outraged nature's laws know nothing of the plea of extenuating 
circumstances. If a certain course detrimental to health he pursued, 
its effects cannot be obviated. A life of severe self-denial and rigid 
care may alone permit of a continuation of the existence imperiled 
by the follies of youth. In youth, the habits and the walk of life 
of the individual exert a decided influence upon the system, and 
often predispose it to disease, and its not infrequent consequence, an 
early death. The constitution becomes broken, and an after life 
of invalidism alone intervenes between this and the final change. 

The extrinsic influences which bear upon health, and indirectly 
upon longevity, are in action incessantl}'. The awards of nature are 
sternly just, and the consequences, call them punishments if you 
will, are in strict proportion to the offense. Constantly and unin- 
terruptedly are the forces in action around us, which will, in addi- 
tion to one's own habits, determine the question of health or the 
absence of it. and with the latter, the ultimate question of survivor- 
ship. The constitution may not only be subjected to open and 
visible assaults, leaving distinct traces of themselves behind, indeli- 
ble and never to be obliterated, but it may also be insidiously under- 
mined. 

A suppurating process may and too often does, go on until the 
foundat ; ons of health and strength have been utterly destroyed, and 
a sudden col 'apse is the first outward intimation of the fact. Nor 
does such a sapping go on without the consciousness of the indi- 
vidual, if he would but listen to the ominous warnings — but 
whether there be consciousness or unconsciousness, and whether 
the latter be simple or from voluntary effort, it matters not — 
the work is pressing steadily forward, as the result demonstrates. 
Even when life is approaching its close, health and life are not alto- 
gether removed from the action of the habits of the individual him- 
self. It has been beautifully said that "the line of health has on 
each side a margin, within which it may vibrate according to disturb- 



193 MEDICAL PRACTICE. 

ing causes, without actual illness resulting. Without that margin is 
another permitting of still further oscillation, compatible with life 
but not with health; this is the limit of possible recovery. The 
oscillations may approach the outside of the margin, and yet the 
equilibrium be recovered; the nearer the margin is approached the 
greater the danger. Beyond that outer margin life is permissible for 
a little time longer, but the equilibrium is too rudely shaken ever to 
recover itself. The margin of each boundary is more easily reached 
after repeated and persistent assaults upon the health, and con- 
sequently lesser exciting causes of disease become serious. An oscil- 
lation arising from some disturbing cause which would, in health, 
scarcely extend beyond the first margin, will reach far into the second 
margin, if those limits have been previou-ly reduced; and a disturb- 
ance which would scarcely have amounted to sickness, now reaches 
into serious illness. A ruder oscillation, which, in a healthy person, 
would not exceed the limits of possible recovery, in another extends 
beyond that margin and death quickly follows." Such is an expla- 
nation of the suddenness with which many apparently healthy per- 
sons succumb to what is regarded as scarcely serious disease. 

This forcible illustration demonstrates pointed'y the great import- 
ance of caring for the health all through life; not only for the enjoy- 
ment of he llth, the avoidance of the discomfort of illness, but also 
for the maintenance of the existence of the organism. 

Whatever has a tendency to enfeeble or arrest the vital energies of 
the system, is injurious, wheiher it be cold, grief, want of proper 
nutriment, over-anxiety, excitement, excessive labor, or long con- 
tinued activity of the brain in literary pursuits; everything that 
draws on the nerve force beyond its legitimate and proper require- 
ment, is a direct and positive source of evil, and sooner or later 
brings with it pains and penalties. 

In order to obviate the influencesof hereditary physical infirmities, 
careful hygienic training must be commenced in the earliest periods of 
childhood. Careful culture will do much to modify, as irregularity 
will assuredly aggravate the consequences of a faulty organization. 



POPULAR KNOWLEDGE. 199 

In early youth is laid the physical and moral foundation for the habits 
of after life. 

The physical and moral powers hold the same relations in life that 
the main-spring and balance-wheel hold in the motive power of the 
watch; one gives the stimulus of action, while the other gives char- 
acter and correctness to the motion and its indications, and from 
their mutual dependence the slightest variation of the one imparts a 
portion of the derangement to the other, and in accordance with the 
intentions and ability of the maker is the perfection of his work. In 
childhood and early youth the powers of observation are keenly 
alive and retentive, and all words and acts are garnered for the direc- 
tion of future life. Indeed, such knowledge is the polar star of 
existence, the guide of sorrow and happiness, whose refulgence is in 
a measure optional with those to whom the early training is in- 
trusted. 

If parents could but lift the veil which shrouds the future and see 
the misery they are entailing not alone upon themselves, but also upon 
those who derive their being from them, by their violation of nature's 
laws, their sinful habits and vicious indulgences; if they could but 
foresee the sorrows, the suffering and misery which they are gather- 
ing for their declining years; how few would persist therein ! 

A man may have the right to do many acts that produce but tem- 
porary injury, but he has no right to permanently impair Ids health, 
shorten his life, and especially to transmit enfeebled constitutions to 
his children. As he has no right to do this, it is his manifest duty 
to study the laws of health for himself ; and, so far as it is in our 
power let us see that the rising generation is properly ins'ructed. It 
is not valid reasoning; to say that these matters pertain exclusively to 
the practice of medicine, and should not be meddled with by the peo- 
ple. A man's life is his own, his health is his own, and in the preser- 
vation of both he has more interest than any other person. 

THE PHYSICIAN'S ATTAINMENTS. 

While I advocate the diffusion of knowledge among all classes, I 
do not wish to be understood as recomm&nding that each person 



200 MEDICAL PRACTICE. 

should be his own doctor, because to obtain the highest degree of 
skill in any art, it is necessary that it should be studied with great 
care, and that the entire time be devoted to it. Hence, in the prac- 
tice of medicine, the most intricate of all arts, it becomes necessary 
that those who pursue it should have a thorough medical training in 
order to become skillful workers. Not only does it require reading, 
but, as in nil other arts, it requires that experimental knowledge 
which is only obtained in well-conducted colleges and hospitals. 
Not only is it necessary that the physician should have spent years 
in the study of his profession, but he must also have a 1 >ve for it in 
order to prove successful. 

THE DOCTOR'S STATUS. 

The vocation of the physician is the spirit of true Christianity in 
action. It consists not alone in healing the sick, in soothing the 
afflicted and recalling the wandering intellect* but also in cherishing 
a love of peace and veneration amongst all men, and in promoting 
moral and intellectual improvement. The practice of the healing 
art is an occupation intrinsically dignified. It cannot be divested of 
this quality by the humble condition of the practitioner or by the 
repulsive nature of many of his duties ; still less by the lowly con- 
dition of his patient. In the most abject human being the true 
physician recognizes a fellow man ; in the most exalted, nothing 
more. The offspring of the highest and the lowest, in the first 
moments of their existence, come under his care, alike naked and 
helpless. The screen which in after life conceals many of their 
weaknesses and some of their virtues, ever open, more or less, to 
the medical observer, is for him removed by sickness and by mis- 
fortune. Before the man of healing, the trappings of greatness are 
laid aside, and the cloak of deformity is dropped. Beauty puts off 
her ornaments and without a blush modesty raises her vail. And 
when at last, man is about to take his plunge into the abyss of 
eti rnity, he strips off all disguise and stands revealed in his primi- 
tive nakedness and helplessness. Surely those who hold such, 
relations to society should be learned, discreet and wise ; trained by 



A MODEL PHYSICIAN. 201 

liberal studies and by illustrious examples, to be ever true to the 
cause of humanity ; elevated by education, as by education alone 
they can be educated, to rise above' all that is sensual and sordid. 

THE MODEL DOCTOR. 

It is generally conceded that poets are '"'born, not made." We 
have with much reluctance come to the same opiuion respecting phy- 
sicians. It is noticeable that the most prominent and noted show a 
genius in their adapt ibility to the profession and its labors not' 
remarked in acquired talent. Whether in office consultation, in 
counsel with his professional brethren, or at the bed-side of the sick, 
such an one is pre-eminent and usually impresses the observer with 
the fact. He is a gentleman in every respect, possessing " suaviter 
in modo , forliter in re" gentleness in manner, courage in emergen- 
cies. Exceptionally we find a rough diamond of value, but while this 
personal magneti>m may affect some advantageously, to others it may 
be, and often is, detrimental. He also knows that nervousness, 
idiosyncracies and the like, have a physical cause which he seeks 
and endeavors to remove. He is learned in his art and has a fund of 
resources always available. The absence of his medicine chest or 
the want of a particular remedy does not di- concert him; from the 
meagre material at hand his skill will supply all necessities. The 
true physician is always in earnest. He does not allow a case to be- 
come grave or hazardous before he displays proper interest. He 
knows that the patient has a right to exoect immediate improve- 
ment and laboring for that end, usually effects his purpose. He 
is as much interested in a sudden cold as a typhus fever, as much 
in a fever as in a cancer, as much in a cramp as in a cerebro spi- 
nal meningitis. With the daily weary round among the sick, it is 
no wonder that some become callous; still, knowing the possibility 
of such a condition, a studied effort should be made to avoid it. 

" The true medical man will tell you what is wrong. He will do 
so in simple language, perfectly intelligible to the ordinary man. If 
he talk*; ibberis'.i for the purpose of bamboozling you, he is worth- 



202 MEDICAL PRACTICE. 

less and you can get no good from him. But if he is a true man lie 
will tell j^ou what is wrong as no one, not trained as he has been, will 
possibly be able to tell you. He may be mistaken, no doubt, but he 
will not usually be so. And it is surely a thing of great use to learn 
what is wrong, even if you cannot be told how to remedy it." We 
are pleased with his uprightness and candor; he cannot cure every 
disease that comes under his observation, and is frank enough to dis- 
possess your mind of any such impression. When sick in bed, he ' 
has many things to tell you about diet, air, sunlight, bathing, but 
little medicine to give. The expert healer knows that the simple 
swallowing of medicine is of but little avail, and in his attempts to 
help nature he is exceedingly cautious not to retard the healing pro- 
cesses. 

If the instructions are many in an acute disease, they should be 
much more numerous in a chronic affection. A single prescription 
must partake of the miraculous (and we have yet to see anything su- 
pernatural in the art) that would remove the morbid condition of 
years' standing. 

He will patiently listen to your suggestions and if any have merit, 
he will approve of them, and if they are the means of your recover- 
ing he will glory in their results as much as yourself. He will ad- 
minister only remedies that are pleasant to the taste. The advance- 
ment of chemistry and pharmacy has of late years been so rapid and 
they have reached such a degree of perfection, that any disagreeable 
medicine can be completely disguised. 

Our model does not hesitate to give instructions and advice in the 
practical application of hygiene. In doing so it is apparent he works 
against his own interests as a business man. The principles of hy- 
giene have in view the prevention of disease. Diseases are preventi- 
ve, with the exception of a very few, — notably accidents and old 
age. The laws of .Nature are immutable and ignorance affords no 
excuse or palliation, hence no fears need be entertained that the phy- 
sician will ''go begging." 
If you have such a physician in your midst, as we have indicated, 



NATURE'S WORK. 203 

hold fast to him, for, as Solomon says of knowledge, he "is thy 
life." When his services have been required, cheerfully and prompt- 
ly give him abundant remuneration. No monetary scale can fix the 
value of having such an one as a n< ighbor. Gratitude should not 
be circumscribed by the time you are lying helpless on your back. 
The amount of time consumed or quantity of drugs furnished is no 
standard of judgment in such matter?. Remember he is not a day 
laborer nor a druggist but a Doctor, literally a teacher. One step 
fur. lier- might be hinted and that is add to his office or parlor some 
article useful or ornamental that will be your own souvenir. 

NATURE THE SOUHCE OP REMEDIAL POWER. 

As in surgery, so in medicine, the pow; rs of nature must perform 
the he lin^, and the offices of the physician are but to assist this 
process. There are cases in which it can be done directly ; for in- 
stance, the use of an emetic to remove from the stomach its ferment- 
ing and irritating contents. The extraction of a splinter from the 
flesh is of this nature. His services are of much more value how- 
ever, in the indirect methods he can and does employ ; giving the 
invalid sunlight, even temperature, an abundance of fresh air with- 
out draft, scrupulously clean clothing and bt d linen, and — still more 
important — a clem skin. Cathartics are good in their way but are 
undoubtedly used too freely. The skin is emphatically the best 
outlet we have for impurities in the blood, and it is in this fluid that 
disease germinates. Even the kidneys and liver, other great purify- 
ing organs, do better if the skin has been freely purged by the use 
of the Turkish or alcohol vapor bath. Such purification, combined 
with proper diet, assists nature both in r< storing the blood to its 
natural condition, and also in furnishing those elements only, which 
will maintain it at its proper standard. The continued use sd such 
means may be successful in eradicating hereditary taint. Persons 
so afflicted should endeavor in every way, and that continuall} 7 " — to 
enhance their vitality, to increase their vital energies — so as not only 
to prolong their own lives but those of the coming generation. 



204 MEDICAL PRACTICE. 

The healthy germs of the future life can only be formed by pure 
blood, and this in turn is dependent upon the normal activity of all 
the organs of the body, and the diet, which is its chemical basis. 

We are as much subject to nature's laws as material things, and 
nature's laws are immutable. The vio'ation is invariably and in- 
evitably followed by disturbing consequences. No age, no condition, 
no position in life secures emancipation; it is therefore reasonable to 
expect that the better we become acquainted with the laws of our 
existence the less we will violate them, and not only escape punish- 
ment and enjoy better health, but attain that strength of mind and 
body which is a safe-guard against contagion and epidemic. 

Medicines, to be effective, should help nature, which in every case 
tends of itself toward recovery ; or, converse -y, they should be such 
as will not make a well man sick. Pure air, sunlight, nourishing 
food and those remedies, if any, that will encourage the functional 
activity of the eliminating and secreting organs, are of this char- 
acter. 

MEDICINE IN SMALLER DOSES. 

Mistaken fanaticism has spoken of the " vile, polluted body," and 
has assigned to Providence what men owe to their errors alone. No 
ordinarily educated person can be imposed upon by quack medicines 
which cure all diseases. The homoeopathic heresy has at length dimin- 
ished our nauseous draughts ; blood-letting at stated intervals is one 
of the absurdities of our grandfathers at which all enligbtened peo- 
ple laugh. Even physicians antt apothecaries have begun to diminish 
doses and to prescribe less medic'ne and fresh air, less treatment and 
more exercise, less cures and more preventives of the causes of dis- 
ease. Marvelous changes have been made and many improvements 
may be noted since Moliere sneered at doctors and their tricks; but 
much yet remains to be done to make people generally understand 
the laws of health and avoid the many maladies which ignorance 
inevitably entails. 

PROFESSIONAL ERRORS. 

Gen. George Washington was taken with croup, which an appli- 



HEALTH OFFICERS. 205 

cation of cloths dipped in cold water would probably have cured in 
a few days, but he was bled again and again, and so died. President 
Harrison, notwithstanding his age aud infirmity, was cupped, leeched 
and medicated with the usual result. The Duke of Kent, the father 
of Queen Victoria, is said to have died of remittent fever. The 
truth is, be was bled to-death by the abstraction of one hundred and 
twenty ounces of blood. And one of the most eminent physicians 
of the day said that if be had been called sooner, he should have bled 
him more freely. Prince Albert died in the flower of his manhood, 
of typhoid fever. There is little doubt lhat he might have been 
living now had he been properly treated. 

BOAKDS OF HEALTH. 

When it is possible to separate politics and its consequent incom- 
petency from the appointing power Which shall give to us boards of 
health, a public demand will be made for such authorities. There is 
at the present time and ever will be, an abundance of labor for men 
of worth, of liberal education, and practical medical knowledge. 
The facility of modern travel, whether by railroad or steam vessel, is 
such that the invalid can journey many miles with a comfort almost 
equal lo that of home; just stricken with an infectious disease or 
just recovering from such an attack, it is possible to spread a conta- 
gion over great distances, through a score of towns or villages, and 
in houses that may be counted by the hundred. Instances have hap- 
pened in which ladies, broken out with the small -pox, have traveled 
many miles, escaping detection by being closely veiled; " others who 
have had this disease in a mild form, appear at will on the highways, 
every moment their bodies throwing off a little cloud of infecting 
dust." At present, restriction can only be placed upon the inmates 
of an infected house, but hundreds may leave a neighborhood, passing 
through an epidemic, and mix with the travelling public. 

Possibly physicians are culpable for neglect in cautioning the fami- 
lii s they visit against the too early appearance of children just recov- 
ering from scarlet-fever, measles, small-pox and the like, upon the 



206 



MEDICAL PRACTICE. 



streets, in the school-room, or among their playmates. Scales which 
are thrown upon the air are fructified germs, and if they find proper 
soil, will invariably produce their blossom and fruit. Intelligent 
heads of families and educated nurses seldom take the caution which 
they know to be necessary in such matters until harm has been done 
Knowing that in typhoid fever and in cholera the excretions of ihe 
bowel are poisonous, they hurry them away from the room and the 
building an \ deposit them in privies or upon the ground to be wafted 
upon the winds to the nostrils of the passer-by, or to be carried to 
the rooms of houses in the neighborhood. How simple in such cases 
to have them deposited in vessels containing a disinfecting fluid or 
if this is not possible, to r» ceive the discharges in cloths, and imme- 
diately immerse them in tubs or pails partly filled with the solution. 

EPIDEMICS. 

Fortunately great epidemics do not always increase the average 
mortality. This fact is instanced in the case of cholera, and again 
m that of small-pox in London. Those who die in such cases would 
have died of other diseases. No epidemic attacks everybody They 
have cholera or measles or small-pox who are in a condition to take 
such diseases. Four-fiths of those who die of epidemics are 
already in a diseased condition, so that what seems to be fatal 
sometimes does not increase the rate of mortality. The best safe- 
guard against disease is to be well-to habitually observe the laws 
of health. Health resists al! caus.s of disease and is the most sub- 
stantial safeguard when one particular kind of disease, especially of 
a contagious character, is counting its victims by hundreds. Really 
healthy people do not have epidemics, those who are strong enough 
to resist do not de of them. Those who have the conditions and 
treatment that all ought to have, recover in a great majority of 
cases. J J 

CONTAGION. 

This subject should receive more attention than it does. Persons 
moving from one house to anoher should not be satisfied with the 



MORTALITY CAUSES. 207 

fact that their new location is comfo; table and convenient, and that 
its hygienic arrangements are proper, but inquiry should be made as 
to the cause of removal of the late tenants. If this has been from 
disease and the disease was infectious, the premises should be 
shunned until thoroughly disinfected and ventilated. 

MORTALITY CAUSES. 

In cities, where greatest mortality exists, we find crowding, 
filth, imperfect drainage, stagnant air, poor ventilation, bad or 
deficient water supply, adulteration of food, the refuse of the 
markets, drunkenness, vice, crime and every form of human 
wretchedness. 

HYGIENE. 

It may be taken for granted that sanitary science has established 
two things : First, That when drinking water is contaminated by 
sewage, those who drink the water are in danger of suffering from 
typhoid fever, diphtheria and other febrile ailments, classed together 
under the term ' Zymotic.' Secondly, that when gas from sewers or 
from leaking drains makes its way into a house, the inmates are in 
imminent danger of an outbreak of such zymotic diseases, not to 
speak of minor illnesses, the connection of which with sewer gas is 
more than suspected. 

CLOSE CONFINEMENT OF THE SICK. 

Dr. P. Niemeyer writes:— "It is a peculiarity of consumption that 
it may appear in association with all diseases in which recovery is 
slow. In the first place, it accompanies inflammation of the lungs, 
unless the patient, while recovering, is permitted to breathe plenty 
of pure air. But it also makes its appearance fn typhus, diabetes, 
and meningitis, when the patient is kept for a long time in a close 
room. So, too, delicate persons — those supposed to tend toward 
consumption — will all the sooner become indeed ' tuberculosed,' 
the more they are coddled, protected against cold, and treated with 
warm drinks and so-called ' invigorants.' " 



208 MEDICAL PRACTICE. 

SICKNESS IN THE FARM-HOUSE. 

In an essay upon Occupation which, appeared in the " Sanitarian," 
Dr. Bartlett of Conn, paints th^ picture in its true color. He re- 
marks: " The causes of disease then, which fall to our consideration 
as due to occupation, are those pertaining to farm life, as relates to 
the male portion of the community, and to domestic or indoor life, as 
relates to the female sex. The question then, at once arises, is farm- 
ing healthful? It would seem to be the height of folly to attempt to 
disprove, or even criticise this almost universally accepted belief. 
Let it be granted that the principle is true, yet there remain certain 
aspects of it through which the lover of honest criticism can easily 
penetrate. Farm life possesses three beneficial elements: (a) con- 
stant physical development, (b) abundance of pure air, (c) absence of 
excess and simplicity of life. Against this must be set three ele- 
ments of danger: (a) constant physical and mental strain, (b) irregu- 
larity of life, (c) exposure to the inclemency of the weather. That 
it is possible for the farmer to so conduct his affairs as in a great 
measure to reap these benefits, and not expose himself to the dan- 
gers, cannot be denied ; but practically he does not often do so. A 
sketch of a farmer's life will make this apparent. A young farmer 
sets out in life, ambitious of a competency. He rises early, and 
goes at once to his toil. After a hasty breakfast, the regular labor 
of the day is begun, and continued until noon, when he gives him- 
self a short dinner hour, then resumes his labor and continues it 
through the day, till, worn and weary, he seeks his home at night. 
Completely exhausted, too tired for recreation, he is obliged to spend 
his evening in quiet to recuperate himself for his next day's work. 
Often he rises in the night-time and takes a long journey to the 
neighboring market, ex osing himself to the chilly night air, and 
careless as to his clothing ; and if he returns before the day is 
doue, takes up some unfinished task and continues his labors again 
till night, devoting but scant time to rest and food. This course 
of life is continued day after day, and year by year. In the meantime 
he is economical, and laying up a competency; but is steadily break- 



OVER-WORK OF FARMERS. 209 

ing down his physical health, as his weary constitution and stiff 
joints so often testify. 

Thi, surely is a picture of excess, and one in which the good 
elements of farm life are sadly perverted and misused. It is not 
only a physical ^ ear and tear, but what is more, the mind often 
becomes broken or enfeebled in its operation. The records of the 
Connecticut Hospital for the Insane, for instance, show this with 
startling emphasis. An inspection of them shows that of the whole 
number of males admitted from the beginning, of the various occu- 
pations J 70 are farmers, the total number being 773. We now pass 
to speak of farmers' wives. The same records show that, of the 
whole number of females admitted from the beginning, which is 
558, 215 are housewives, and, of course, for the most part the wives 
of farmers. When one considers the method of life of this class of 
persons, it does not seem so surprising. Take for an illustration a 
young farmer's wife, the companion of him who has served as our 
previous example. She may not be very strong physically at the 
outset; but be that as it may, she enters into all the plans of her 
husband with alacrity she assumes the entire control of the house 
and docs her own work; this is well enough at the outset; but soon 
she enters upon the maternal state, and a young and increasing fam- 
ily becomes a part of her care, and draws upon her in a two-fold 
way; she bears not only the physical strain of child-bearing, but 
also continm s to perform her own household duties; her husband's 
business still increasing, adding more yet to her already multiplied 
duties; but still she presses on. and so continues, till her pale, 
anxious face and weary step tell of a constitution broken at once 
mentally and physically. This is no imaginary picture, but one 
enacted continually among our farming people today. The average 
farmer's wife is one of the most patient and over-worked women of 
the time. One has only to attend one of our village churches some 
Sunday in the summer to obtain a critical view of our over-taxed 
farmers and their wives; a glance over such an assembly reveals a 
set of faces whose very lineaments are drawn and wrinkled from 



210 MEDICAL PRACTICE. 

overwork ; they tell of lives of constant, unremitted toil, the signs 
of which even a Sabba.h day's rest cannot at all efface. It may not 
be necessary to speak of the occupation of the children, yet there are 
one or two points not to be overlooked. It has passed into a truism, 
that farm life is the right kind of life for a pale sickly boy, but true 
as this may be in a general sense, there are yet many exceptions 
which should not be overlooked. Take, for instance, the j-ounger 
child of this pair above described. He is, perhaps, a weak, frail 
child, and when he reaches the age of six or eight years, he begins 
to lab >r on the farm, doing such light work as he is supposed to be 
able to bear. As he grows older his tasks increase, at the same time he is 
pursuing his course of study at the district school ; but gradually he 
acquires the same habits as his father, and his growing body h 
subjected to a strain which it is ill able to bear, and he grows up 
weak in body and in mind, an old man at twenty, or it may be he 
dies of phthisis engaged in the very occupation which popular 
opinion calls the most healthful. It would not have been so in his 
case had his life been properly guarded, and he would have de- 
veloped into healthy manhood, had his labors been properly adjusted 
to his strength and his life been conducted upon hygienic principles. 
Parents, in choosing a course of life for their children, should con- 
sider whether the child can bear the strain of farm life, and whether 
it coincides with his mental organization, and should so shape his 
course that he shall leave the farm at a proper age for some other 
occupation if his constitution so demand?, and then the sickly young 
boy often develops in strength and bodily health. The cry so often 
uttered, "keep the boys on the farm," is a senseless one, indis- 
criminately applied, and crude in its working ; for the boy who is 
not adapted to that occupation should not be subjected to it any more 
than the thin-skinned, delicate-limbed horse should be harnessed 
down to the plow." 

NERVOUS DISEASES. 

la this high-pressure age, rest is one of our greatest necessities. It 



ENNUL 211 

is a curious fact that a blunt razor, if put aside for a while, will come 
right of itself; in the same way, if we give repose to the brain, 
stomach, muscles, etc., they will soon recover their " edge " again. 

The social causes are " bad and insufficient food, bad air, unwhole- 
some habitations, injurious occupations or want of occupation and 
education, and intemperance, chiefly though not wholly, alcoholic." 
There is a large amount of secret drinking not only among men, but 
among women. In some circles the opinion prevails that the limits 
of alcoholic traffic have been reached in this country and that the in- 
creasing restrictive legislation and the popularity of " blue ribbon " 
and other temperance organizations, indicate as much. Observations 
in different places and among many families and individuals disclose 
other and more injurious substances to be substituted. These are 
opium, morphine, chloroform and chloral ; and to intensify their ac- 
tion an hundred-fold some resort to sub-cutaneous injection. Above 
all, these should not be taken or used by the nervous, hysterical or 
hypochondriacal; nor would any intelligent physician administer 
them to such temperaments. Here many nervous systems are 
wrecked. 



"Ennui" is enumerated by Dr Noviet among things eminently 
destructive of life. We have scarcely its equivalent in the English 
language; but it is idleness in youth, surfeit in the adult, weariness 
and despair in old age. Whatever induces moral depression is as 
baneful to existence as that which induces physical depression. 
Firmness of will is, therefore, one of the most powerful sanitary 
means. The seven cardinal virtues were faith, hope, charily, temper- 
ance, justice, patience and force. The seven mortal sins, pride, ava- 
rice, idleness, luxury, envy, anger and gluttony. The first are favor- 
able to long life, and the others fatal to it. The force of the will, by 
giving a high tone to the more noble faculties of the soul, strengthens 
the principles of life, and enables both mind and body to resist all 
that is pernicious and hurtful to it. Fear or indecision, on the other 



212 MEDICAL PRACTICE. 

hand delivers it up, helpless to the enemy. Energy in doing good is 
still more sustaining than even strength of will devoted to mere sel- 
fish ends. It is this feeling which enables a medical man to perforin 
his duties with cheerfulness and impunity in time of p'estilence and 
plague. Fabrizzi, afflicted by a fatal complaint, withdrew to the 
country to die. A family of p^asauts supplicated his aid in the case 
of a disastrous accident, and th ir gratitude was so lively and sin- 
cere for the cure effected, that the physician felt that if his life was 
not utterly useless he had no right to abstract it from that of others. 
He resumed his labors, recovered his health, and livid to a good old 
age. Barthez, Fodere and Huf eland all believed that great power of 
will could induce prolongation of life. It is certainly powerful to 
relieve. Kant used to say that most nervous disorders are due to 
idleness and mental ine: tia. Many conditions of debility, discomfort, 
distress and sickness arise, indeed, from fretful and cowardly giving 
way to corporeal sensations. The great French Revolution roused 
many poor, sickly and languishing persons to health and activity. — 
(Harpers' Weekly.) 

There is but one royal road to success — work. Grant in arms, 
Stewart in commerce, Webster in oratory, and Field in telegraphing, 
tell us one story — work. Fortunes do not float to us on a smooth 
sea. Culture of heart and brain does not fall upon us like the light 
of the morning. The price of all excellence is toil. 

More thin anything else the world wants is workers. Nature is 
waiting for them. Science waits. Reform waits. God and human- 
ity wait. We fail not for want of endowments, but for want of use 
and application of our powers. A thousand men go to a horse race, 
and squander time and strength enough to bui'd a mile i f railroad; 
the one passes like a vapor, the other would live for ages. 

The want of the age is not genius, but work. Success is a splendid 
prize, but is gained by that mastery of self which despises ease and 
indulgence and determines to win. We want workers in legislation. 
There arc enough to take the emoluments of office. We have enough 
such characters to pauperize the nation. Give us honest workers in 



IMAGINATION. 213 

our halls of legislation, and we shall grow to a happy and exalted 
destiny. 

Every stroke of honest labor helps on the world's success. He 
who multiplie's the fruit of labor Llesses the world. Whatever helps 
to keep the heart pure and the life virtuous strengthens the arm of 
the worker. Vice cheats humanity and sin robs society. 

We all labor but in a different sphere. The building of humanity 
is to go up. The work of every man is essential to its symmetry 
and completeness, aud there should be no schism among its build- 
ers. Happy those who can bring stones of beauty to shine in the 
building, and still happy they who may but lay a rough block in 
the foundation, to support the rising structure, and receive their 
meed of praise, when the cap-stone shall go up with rejoicing. 

CHEERFULNESS. 

Happy dispositions 1 people are generally healthy people. The 
mental condition has far more influence on the bodily health than is 
geuerally supposed. It is true that the ailments of the body cause 
depressing and morbid conditions of the mind; but it is no less true 
that sorrowful and disagreeable emotions produce disease in persons 
who, uninfluenced by them, would be sound in health. Agreeable 
emotions set in motion nervous currents which stimulate blood, brain, 
and every part of the system, into healthful activity; while grief, 
disappointment of feeling and brooding over present sorrows or past 
mistakes, depress all the vital forces. To be physically well, we 
must, in general, be happy. The reverse, however, is not always 
true, for one may be happy and cheerful, and yet be a constant suf- 
ferer in body. Still, even in those cases, cheerfulness will be found 
a wonderful lightener of pain. 

IMAGINATION AND WILL. 

The mind and body bear such an intimate relation to each other 
that disorder in one occasions disorder in the other. They are affected 
very frequency by the same causes, and exert a reflex influence upon 



214 MEDICAL PRACTICE. 

one another. Keeping these facts in view, we can often trace and 
remove the source of real or supposed illness without the physician's 
aid, and thereby avoid much pain an J many prescriptions. It may 
be asserted with s ifety that fully one-half of the sickness of the 
present day is fictitious, unreal. " Imaginatio general caumm," the 
proverb of the schoolmen, holds true to-day — "The imagination 
creates what it imagines." Being well, we think ourselves into being 
unwell. Suffering from ennui and lack of exerci-e, the lady in the 
boudoir takes to her bed under the belief of illness, and the hale 
farmer magnifies a chest pain into dyspepsia, on being told that this 
malady is becoming very common in the rural districts by reason of 
too much pork-eating. Physicians are applied to by hundreds to 
cure troubles whose existence has merely been as-umed from the 
perusal of spurious medical books, scattered broadcast by charlatans. 
The knowledge of the fact that it has been hereditary in their fami- 
lies, has been sufficient to bring insanity upon individuals. Proofs 
of the powerful influence of the imagination on our corporeal nature 
are to be drawn from every quarter. "Writing of the Chinese, Ricci 
says: " If it be told them that they shall be sick upon a certain day, 
when that day comes they very frequently will be sick, and will be 
so terribly afflicted that sometimes they die upon it," An instance 
is on record of a condemned man being found dead on the scaffold 
when the sheriff unbound his eyes, preparatory to reading his 
pardon to him. It was one of Frederick the Great's soldiers, if 
we mistake not, who dropped dead when, after a burlesque court- 
martial, twelve comrades discharged a volley of blank cartridges at 
him. A woman, thinking that she had swallowed a pin, was seized 
with severe pains. A companion, be'ieving it was a mere fancy, 
caused her to retch, at the same time placing a crooked pin at the 
b >t torn of the basin. One seeing the latter, she supposed that she 
had cast it up, and was at once relieved of her pains. 

Tin- exercise of the will has very much to do in determining our 
physical condition. Many persons with weak constitutions but strong 
wills, have staved off sickness year in and year out, when others with 



FORCE OF WILL. 215 

less resolution would have settled into habitual invalids. So bent was 
Cardinal Richelieu upon carrying out his colossal schemes that he 
systematically ignored his physical ailments, and, to persuade the 
people that he was well, frequently rode out before them in military 
dress, with a huge red feather in his cap and a sword dangling by 
his side. John Randolph and Alexander Stephens are signal exam- 
ples of what a strong mind can accomplish, though joined to a feeble 
body. Many instances are reported of persons who have recovered 
from physical maladies through the power of the will, when medi- 
cines failed. Mr. Walker, author of the ''Original," tells us that 
" on one occasion he determined to be well, and he was so." Exas- 
perated at the eagorne-s of his people to hurry him to the tomb, Louis 
XIV. ordered a review of the army. Then, rising from his death- 
bed, he " rouged his pale and haggard cheeks, wigged his thin locks, 
padded his skeleton limbs," and dressing himself in the juvenile cos- 
tume of earlier years, mounted a magnificent charger and partici- 
pated in the military pageant at Marley, which drew people from all 
parts of Europe to witness it. Muley Molus, the Moorish chieftain, 
on being told that his army was hotly engaged with the Portuguese, 
hastily sprang from a pallet of straw, broke through his attendants, 
who were watching for his death, and placing himself at the head 
of his troops, won a crushing victory, and then lay down and expired. 
Determined not to yield to the common enemy, Fontem lie leaped 
from his couch at the age of ninety-eight, and proceeding to a royal 
ball, led the dance. A few years ago a Methodist missionary from 
the Church South to China, was sojourning in Knoxville for a short 
time, during a visit home. The family of Parson Brownlow sent 
for him to go and see that eccentric individual, observing that he was 
near his end, and they were somewhat anxious concerning his 
spiritual condition. Acceding at once to the request, the missionary 
was shown up stairs to the parson's room. The latter lay upon his 
back, his eyes being closed, and his limbs riyid. Apparently his 
end was near. Taking hold of his hand, the missionary said — we 
repeat the incident as he related it to us — "Parson, your friends 



216 MEDICAL PRACTICE. 

think you are going to die, and are solicitous concerning your 
spiritual condition. I have come to talk with you." No sooner 
had these words dropped, than the sick man bolted upright in bed, 
and turning his eyes fiercely on the missionary exclaimed : " You 
can go and tell my family not to be anxious about me or my soul's 
salvation. I shall live for twenty years yet to fight the hard-shell 
Baptists and the Democrats." The thought of having to abandon his 
long-continued warfare seemed to nerve him to make a fresh struggle 
for life. From that moment he began to recover, and in a few 
weeks' time was restored to his accustomed health. We could, 
were it necessary, name other instances, hardly less striking, of 
individuals who have prolouged their lives through their determi- 
nation not to die. (Xew Dominion.) 

OTHER INFLUENCES. 

On the other hand, disease is rendered more deadly, and indeed is 
often induced, by fear. Men, otherwise in robust health, have per- 
ished from fear alone. Sick persons often die many hours or days 
sooner than they otherwise would, because of having been assured 
that they cannot recover. Many persons who perished in the French 
Revolution were beheaded after they had actually died ; the " bitter- 
ness of death " having passed as the executioners fastened them to 
the fatal plank. Little or no blood flowed as the head was severed 
from the trunk. Madame Roland lived till the last moment. 

It seems obvious, therefore, that in the matter of sustaining vital- 
ity, it is of the utmost importance to keep up the strength of the 
will. Make it worth a sick person's while to live; give him confi- 
dence that he can recover; inspire him with the purpose to get well, 
and very few persons would die except those who perish from old 
age or accident. Let the physician carry health about with him, all 
through his own soul, and his patients will be infected by him, so 
that they will often even recover from that cause alone. Health is 
the most contagious principle in existence. 

We have learned what we know of cc ntagion on the morbid side, 



OTHER INFLUENCES. 217 

just as we know anatomy and physiology from exploring corpses. 
"We seek the living among the dead. We are all cognizant of the 
theories of communicating disease, b} r spores of pestilence in the 
atmosphere, distributing small-pox, cholera, plague, and a host of 
maladies. We are depressed and melancholy, or gay and cheerful, 
when some person, often at a considerable distance, with whom we 
are en rapport, is in a like mood; and we often think of persons at 
the moment that they approach us. This is contagion. A sensitive 
person can tell whether another person, or even an animal, is nearby. 
A merry party will make us vheerful, and gloomy company will 
oppress us with low spirits. Presentiment and foreboding are often 
morbid affections derived from others. Dyspepsia is as often as other- 
wise the sequence of being in unsuitable company. We have often 
experienced it from the contact of another person's despotic will. 
Nervousness comes from monotony and unwholesome associates, as 
well as from s'rong coffee and indigestible food. An imperious over- 
bearing person often enfeebles the body as well as the will of 
one of more delicate organization. Even in the case of married 
couples, morbid conditions are induced from their near p< rsonal rela- 
tions, when not attended by true analogy of disposition and tempera- 
ment. Hypochondria, hysteria, dementia, paralysis, even consump- 
tion, are results of like association. Many persons appear to subsist 
on the vital emanations which they derive from others. King David's 
experiment with Abishag, the Shunamite, is an example; and the old 
alchemist, Roger Bacon, cited it, as constituting the only known elixir 
capable of prolonging physical life. On the other hand, the contact 
of a diseased or dead body poisons the blood and abates the vitality 
of the living. The dissecing-room is noxious because of the pres- 
ence of the cadaver, rather than from the decomposition. Addresses 
from the pulpit or in the public hall often devitalize the hearers, by 
reason of the peculiar condition or temperament of the speaker. 
Steeping in a chu'eh is an annoyance and a matter of reproach; but 
it is as often a safeguard interposed by nature to protect us from 
morbid influences, and it is obviated best by changing the air of the 
10 



218 MEDICAL PRACTICE. 

room, as well as the topic and temper of the speaker. Public orators, 
also, in like manner, have their vitality dr.mk away from them by 
persons in their audience. 

For these things there is a law, which it is the physician's province 
to understand. It is impossible to prevent morbid contact or conta- 
gion between individuals, but the mischief of it can be obviated. 
Nature has implanted in the human constitution an antipathy, a re- 
pugnance against persons with whom it is not wholesome to asso- 
ciate. This fact should be carefully heeded. Some persons, by con- 
versing with us, or even by remaining near us, exhaust our stock of 
vital energy. Melancholy persons, those of a despondent temper, 
and persons having consumption, typhus or other diseases character- 
ized by great exhaustion, are sure to do this. Those who cannot 
stand the drain should be upon their guard. The lion, having a man 
in his clutches, is said to fascinate him, and render him hopeless 
or indifferent of life; hence it is well to keep out of the lion's way. 

Fortunately there is a bright side to the picture. Contagion is pri- 
marily the source of life. The embryo derives existence, and main- 
tains if. by the parental contact on every side. Children in a family 
are fed, sustained, and kept in normal condition by absorbing the 
spiritual emanations of their parents. Healthy mental conditions 
will generally destroy morbific agencies, as ozone will neutralize a 
deadly virus. The woman having an issue of blood, which the phy- 
sicians failed to cure, is said to have been healed by touching the 
hem of the gown which Jesus wore; health, vitality, call it what you 
please, which abounded with him, flowing from him immediately and 
healing her ailment. So, he is said to have healed diseases by a 
touch, and cast out demons with a word. Such things are purely in 
accordance with the vital laws, which should be learned and carried 
into practice. Then would disease be understood and treated more 
wisely, as being a disturbance of the equilibrium of the soul. In- 
sanity, the puzzle and plague of medical men and jurists, would be 
better comprehended and cured as readily as any fever, abscess or 
lesion of the body. The causes of diseases would be obviated, and 



PREVENTION. 219 

the physician would carry his restorative in his own heart, in prefer- 
ence to his medicine-case. The future state of existence would not 
be regarded with gloomy foreboding; and death, recurring in its 
legitimate order, would be considered as an every-day matter, timely 
and beneficial. 

We would not overlook nor despise the use of drugs. In the pecu- 
liar physiological phenomena which they produce they are beneficial, 
and, in our present condition of knowledge, we must continue to 
employ them as best we know how. Unluckily, perhaps, but una- 
voidably, we know them chiefly on their more earthly, material side. 
A higher intelligence may, perhaps, be attained, enabling us to per- 
ceive that their peculiar virtues consist in their fixation of certain 
elements of a more ethereal nature, so that thereby these elements 
are kept at hand to be applied where and whenever wanted. This 
idea is not so fanciful as it may appear, but it is philosophical. We 
know that carbon and caloric have been fixed and stored away in 
the anthracite for unaccounted ages; that every vegetable is a recep- 
tacle of vitality, heat, light and actinism. Certainly, the iJea that 
some spiritual, vital, remedial potency is fixed and stored away 
for use in a drug, is no greater play of imagination. Human souls 
are individualized and made personal by the agency of human 
bodies. So, vitalized substances, belonging to the vegetable and ani- 
mal kingdoms, may, in some analogous manner, become agents, 
ministering sustenance, healing and benefit to human beings. 

Howeve'r little practical or philosophical these observations may 
seem, yet we are convinced that they come more nearly to the rational 
solution of the matter than may at first appear, 

EFFORTS TO AVERT PISEASE. 

The faculty of preventing disease, as exercised by the skin, be- 
sides being indirect and operating on the general health of the body, 
is also direct. The skin repels the depressing effects of cold, of 
alterations of temperature, of extreme dryness or moisture, by virtue 
of its own healthy structure, by its intrinsic power of genera ing 



220 MEDICAL PRACTICE. 

heat ; and it also repels other causes of disease, such as animal and 
miasmatic poison, by its emunctory power, which enables it to carry 
them directly out of the body. In unwholesome states of the 
atmosphere, in an atmosphere of malaria, which must necessarily 
pass into the body with the inhaled air, and being in the lungs, 
must be absorbed by the blood, we naturally inquire, by what 
means we escape the morbid effects of such malaria ? The answer 
is : the malariais conducted out of the body as rapidly as it is in- 
troduced, by the emunctory organs — by the liver, kidneys, and 
notably by the skin. If the powers of the skin be weak, the poisons 
are detained in the blood, and disease is the result ; but if the skin 
be healthy and active, then they can do no evil ; and ultimately they 
become innocuous. Thus the bath, by conducing to the health of 
the skin becomes a direct means of preventing disease. 

We hive bile from the liver, urine from the kidneys, carbonic acid 
and water from the lungs, and sweat from the skin. Although each 
of these organs has its special functions to perform, nevertheless, 
one can assist another in case of need. Thus it is found that when 
the kidney is diseased, and fails to take from the blood what a 
healthy kidney takes, the skin in sweat, and the lungs in the breath, 
carry off the products which ought to pass out of the system by the 
kidney. Again, when the liver is at fault, and cannot remove the 
bile, we find that the kidneys and the skin help to pass it out of the 
system, and so we get jaundice. 

TRANSMISSION OF DISEASE. 

" Do men gather grapes of thorns, or figs of thistles ? " Certainly 
not. A tree is known by its fruits, and the same may be said of 
human beings. As is the parent, so to a very great extent, will be 
the child. An immense responsibility rests upon us all in this 
matter, and most urgently and heavily it rests upon those who are 
just entering upon manhood and womanhood. I would ask all 
such to remember that they are the fathers and mothers of the 
coming generation. Every excess, of whatever kind, every sin 



HEREDITY. 221 

against one's own body, all immoral indulgences, record themselves 
indelibly upon us. Whatever evil they work upon us in our own 
persons, they work still more certainly and virulently upon our 
offspring. To the outward eye the adult may appear robust who 
has drawn heavily upon his stock of vitality by debauchery, but his 
children will be puny in body or defective in mind, or perhaps both, 
and early old age will sharply remind him of the sins of his youth. 

It is not convenient here to enter upon a full account of all that 
might be urged against indulgence in propensities which war against 
the body as well as • the soul, but without going into details, the 
sexual sins of parents are a very large factor in the mortality of little 
children. If the functions and powers which Providence has given 
us are*perverted to the base uses of mere animalism, a swift and ter- 
rible reiribution awaits us — our tenderest and best emotions are 
made the instruments of our own punishment, and our dead children 
rise up in judgment against us. It is certain that a very small pro- 
portion of the children who die of constitutional diseases due to the 
vices of their parents are certified as so dying, from the reluctance 
of medical men to label their patients as dying of diseases of w 7 hich it 
is shame even to speak. What the real number is will probably never 
be known, but that it reaches shocking dimensions is well known to 
every medical practitioner. Probably the great bulk of the infants 
(twenty-five to twenty-six thousand) dying of what, for the sake of 
euphemism is called in the certificates "atrophy," "debility" or 
" tabes mesenterica," and the ninety-five hundred who are returned 
as prematurely born, and not a few of those returned in other and 
equally vague ways, really were victims of a disease which ought 
not to exist at all, and which above all other diseases is preventible, 
and an evidence not merely of neglect or ignorance, but of active 
and deliberate wickedness. 

The sin of drunkenness is another parental fault which entails dis- 
ease and death upon unborn generations. Not to mention the dire 
effects in somewhat later years of drunkenness in the parent — which 
expresses itself in the child as it grows up, in the form of epilepsy, 



222 MEDICAL PRACTICE. 

idiocy, mania and dipsomania (habitual drunkenness) — it is familiary 
to us medical practitioners that the children of drunkards are prone 
to hydrocephalus (water on the brain), convulsi ;ns, and a 'whole 
tribe of diseases of a low type, showing general degeneracy and a 
predisposition to brain mischief. If anyone wants proof that the 
laws of naiurc are the laws of God, he will find in the mortality of 
infan s ample illustr .tion of the truth that the sins of the fathers are 
vis : ted upon the children (literally) until the third and fourth genera- 
tions. There is a peculiar significance, too, in the fact — which has 
been proved on a large scale — that drunkenness tends, after produc- 
ing in its fa : al course through each succeeding generation, mania, 
melancholy, paralysis and suicide, to end in complete idiocy and 
extinction of the family in the fourth generation. How manj% inno- 
cent but enfeebled lives go down befoie*the final obscuration and 
destruction it may be p unful, but will certainly be useful, to reflect 
upon, if from the reflection we can lay to our hearts an effectual 
warning against sensual pleasures in any and every form. 

There are yet another cla-s of influences affecting adults, and 
through them their offspring, in the shape of unwholesome and 
debilitating occupations. Those who are engaged in what are called 
unhealthy trades owe it to themselves and to their offspring to insist 
upon the utmost being done to mitigate their evil effects. 

Says Dr. Henry Maudsley : "People think little of the power 
which thej r have over their own destiny and over the destiny of 
those who spring from them. How amazingly reckless they show 
themselves in this respect. They have continually before their eyes 
the fact that by care and attention the most important, modifications 
may be produced in the constitution and character of the animals 
over which they have dominion — that by selective breeding an ani- 
mal may almost be transformed in the course of generations ; they 
perceive the striking c mtrast between the low sava -e with whom 
they shrink almost from confessing kinship and the best specimens 
of civilized culture, and know well that such as he is now such were 
their ancestors at one time ; they may easily, if they will, discover 



HEREDITY. 323 

examples which show that by ill living peoples may degenerate 
until they revert to a degraded state of barbarism, disclosing their 
former greatness only in the magnitude of their moral ruins ; and 
yet, seeing these things, they never seriously take account of them, 
nor apply to themselves the lessons that lie on the surface. They 
behave in relation to the occult laws which govern human evolution 
very much as primeval savages behaved in relation to the laws of 
physical nature of which they were entirely ignorant — are content 
with superstitions wh re they should contrive to get understanding, 
and put up prayers where they should exert intelligent will. They 
act altogether as if the responsibility for human progress upon earth 
belonge 1 entirely upon higher powers, and not at all to themselves. 
How much keener sense of responsibility and stronger sense of duty 
they would have if they only conceived vividly the eternity of 
action, good or ill ; if they realized that under the reign of law on 
earth sin and error are inexorably avenged, as virtue is vindicated, 
in its consequences ; if they c aid be brought to feel heartily that 
they are actually det rmining, by their conduct in their generation, 
what shall be predetermined in the constitution of the generation 
after them ! For a-suredly the circumstances of one generation 
make much of'the fate of the next. 

" I have met with many instances which prove how little people 
are dispo ed to look beyon 1 their immediate gratification in the 
matter. If it were put to two persons passionately in love with one 
another that they would have children, one of whom would certainly 
die of consumption, another become insane, and a third, perhaps, 
commit suicide, or end his days in a workhouse or jail, I am afraid 
that in three cases out of four they would not practice self-denial 
and prevent so great calamity, but follow self-gratification, and 
vaguely trust ' the universal plan will all protect.' 

"Those who pay no regard in marriage to the evils which they bring 
upon the children, nor in their lives to the sins by which the curse of 
a bad inheritance is visited upon them, may plead in excuse or exten- 
uation of themselves the vagueness and uncertainty of remedial 



224 MEDICAL PRACTICE. 

knowledge of the laws of hereditary ac'.ion. We arc unable to give 
them exact and positive information when theynpply to us, and they 
naturally shelter thems- Ives under the uncertainty. The large scope 
of the medical work of the future is 10 discover those laws which 
have been in op ration through the past to make man the superior 
being which he U, and to determine his future action in intelligent 
conformity with them ; not only to cure disease of body and mind, 
as it has aimed to do in the past, and to prevent disease, as its larger 
aim now is, but to carry on the development of his nature, moral, 
intellectual and physical, to its highest reach." 

PROPER FOOD. 

The subject of dietetics stands, at the present time, in much the 
same relation to a healthy digestion that logic does to a sound judg- 
ment. To the man who has a good digestion or a clear head, the 
one or the other science is of comparatively little assistance. On the 
other hand, to dyspeptic individuals the theoretic knowledge of foods 
is of little avail towards producing a vigorous digestion, just as the 
rules of logic do not contract by lines of thought " the straightened 
forehead of the fool." To the healthful all things are wholesome. 
The selection of food may be left to the judgment and taste of the 
ordinary healthy and sane man or woman, and where experience 
fails to answer the question whether a given article of food is whole- 
some or not, the best way is not to consult the doctor, but to give it 
a cautious trial. 

Some individuals, and even whole families, have remarkable pecu- 
liarities with regard to the effect of certain foods on the skin, but 
the cases are rare and do not affect the general question. Every 
one knows how shell-fish, e. g. , mns-els, cau^e nettle-rash. Cases 
are recorded in which even roast beef produced blotches on the skin. 
I doubt, however, if all the circumstances were sufficiently stated to 
prove cause and effect ; it might have been the concomitants of the 
beef that produced the blotches. 



NURSING.. 225 

CHANGE OF DIET. 

It is to be noted that there is some little danger in a sudden change 
of diet from the fleshy, stimulating, and highly-seasoned meal, to the 
plainer, simpler and less seasoned but more nutritious foods. Sev- 
eral friends have found the use of Graham flour to cause diarrhoea, 
and, in some instances, loss of flesh. The transformation should be 
moderate. 

MEDICINAL ACTION OF WATER. 

The medicinal value of water-drinking is incalculable. As a sol- 
vent, a purifier, or tonic, it is beyond all praise. It is richer in 
oxygen than atmospheric air. It allays inflammation, stimulates the 
blood-vessels of the mucous membrane, and, by expelling the blood 
from them, relieves internal congestion. It creates appetite. It helps 
to eliminate the cause of disease by producing the skin irritation and 
boils, known by Hydropathists under the name of crises. It excites 
the action of the kidneys, which are the recognized scavengers of the 
system. It is the best drink in illness, cooling the heat of fever and 
helping nature to throw off in perspiration the morbid influences 
which oppress her. It is very calming to the nervous system, and, 
as we have often repeated, a great aid to digestion. It should be 
drunk the first thing in the morning and the last at night; and we 
are imperative in requiring it should be the only dinner drink. The 
best time for water -drinking is in the morning, and up to twelve 
o'clock. Dr. Beaumont found in his investigations on the stomach of 
Alexis St. Martin, that the coats of the stomach drink in water as 
rapidly as do the sands of the burning desert. 

I have ever found from my own knowledge and custom, as well as 
from the custom and observation of others, that those who drink 
nothing but water are but little affected -by climate and can undergo 
the greatest fatigue and inconvenience. — (Dr. Mosley.) 



Do not wc ar a starched garment, or anything that rustles. Avoid 
all little noises, like the sudden shutting of a door, and the creaking 
10* 



226 MEDICAL PRACTICE. 

of 3hoes. Sometimes the rocking of a chair, or passing the needle 
in and out of work or turning over the leaves of a book or a news- 
paper, makes the difference between comfort and misery in a sick 
room. Do not jar the room by treading heavily, nor the bed by 
leaning against it — above all never sit on the bed. 

Never wake a sleeping patient unless under the physicians orders 
to give medicine or nourishment or to change a dressing. 

Avoid all uncertainty and strained expectations on the part of the 
patient. Keep his mind as quiet as possible. Allow no whispering 
—and even a low tone is far less objectionable than a whisper, which 
the patient involuntarily strains his attention to hear. Ask no more 
questions than is absolutely necessary, and never force him to repeat 
a remark. Never speak to him abruptly. Do not consult him, but 
quietly make the changes you think necessary. Never tax him to 
in ke a decision upon anything if it can be avoided. 

Never let a sick person see, smell or hear anything about food 
before it is brought to him. Let each meal be in the shape of a 
pleasant surprise. Let the food be served with dainty neatness. 

Never let the patient's head as he lies in bed be higher than the 
throat of the chimney, except for au occassional change of posture, 
or in diseases of the respiratory organs. Thus he gets all the pure 
air there is. His head should not be higher than the window and 
placed so he can see out of it. Let the sick room be the brightest in 
the house, and give admittance to all the sunlight the weak eyes can 
bear. 

Do not open and shut the door oftener than is absolutely necessary. 
Do not mislay things so as to be obliged to hunt for them at the 
moment of wanting to use them. 

Do not allow a place in the sick room for flowers emitting a power- 
ful odor, such as tuberoses and hyacinths, but other than highly 
odorous flowers are often beneficial. Place them where he can see 
them without much effort, and remove them at night or at the first 
symptoms of withering. 

The bed should never be pushed against the wall. Let there be 



ADVICE TO INVALIDS. 227 

free circulation of air all around it, and space to go in and out 
without jarring the patient. Do not allow reading aloud unless the 
patient particularly asks for it, and then it should be discontinued 
the moment his attention flags. 

A cheerful countenance in a sick room cannot be too strongly- 
insisted upon. Even if the nurse be tired, she must be careful to 
conceal it from her patient. 

DIET FOR INVALIDS. 

Perfect cleanliness is an essential ; free water drinking is also pre- 
scribed, and abstinence from food which is hot or heavy. Friends 
should remember that they are feeding illness when they tempt the 
sick to (at when the tongue is charged, the pulse quick, etc. Per- 
haps it may be useful to remind our readers that "broth," that fa- 
vorite invalid diet, is only concentrated meat, and therefore quite 
unsuitable under the conditions we have just described. We are de- 
sirous to make it generally believed that little animal food in health, 
and none in illness, is the wisest rule. "Where the constitution is not 
run down by drugs there is little necessity for high nourishment. 
Vegetables, bread, rice, tapioca, fruit, milk, etc. , are the most suit- 
able food for those who cannot exercise. And as water is the drink 
we most generally recommend, we hope it will not be considered too 
troublesome to bring it frequently to the sick-room instead of leaving 
it there for hours to get warm and flavorless. 

It may be worth while warning our readers against, the danger of 
mistaking the prostration of illness for constitutional weakness, and 
thus falling into the dangerous error of giving nourishment in severe 
illness. It will be found that according as illness abates, strength 
returns. We have had patients who the first few days could hardly 
get in or out of bei without help, able to jump in themselves, as the 
disease subsided, though in the interval water was their sole food. 

EXERCISE FOR INVALIDS. 

From careful observation we find that physicians usually lay too 
little stress upon the necessity of out-door exercise. Even if the 



238 MEDICAL PRACTICE. 

amount of motion or action does not amount to what we may term 
exerd e, simply being out-doors is essential. Sitting in an easy 
chair, or — if it is provided with wheels, — wheeling the invalid along 
the walks diverts the mind from the malady, besides the recuperative 
effect it has upon the physical system. If the person is able to walk 
he should be out regularly every day, excepting only the most severe 
weather. In these days of ruhber boots, waterproof coats or cloaks, 
good gloves and umbrellas, there can be no excuse from rain or snow. 
Every observer has noticed the timidity with which the sick venture 
outdoors, when the fact is, they should have more frequent misgiv- 
ings about going into the house. During rainy weather the air 
in the streets of cities is purer and there is less noise and excite- 
ment. In the country you can watch the grass grow greener, take 
in the whole scope of the heavens, see the flitting and ever-changing 
clouds, listen to the babbling of the brook, — feasting the mind while 
renewing the body. 

If the many errors of our ways of living alluded to under the sub- 
jects Hygiene and Physiology should be corrected; if having a fair 
knowledge of the importance of air, sunlight, exercise, diet, dress 
and kindred matters, the reader should put them in practice, further 
chapters in this volume would be unnecessary and the medical pro- 
fession, as a business, be as Othello's occupation, "gone." There 
are thousands in the United States thirsting for just such knowledge, 
and having obtained it, a new lease of life and happiness is insured 
them. It is among these that an author finds his greatest reward, and 
not, as a superficial observer is likHy to suppose, among those who ex- 
alt his labors as an excellent literary production, who laud the inge- 
nuity of his arguments, who praise the vivacity of his language, cr the 
practicability of his conclusions. 

But fortunately for the doctors, and sadly unfortunate for the 
patients, many know the truth and heed it not. A bath every day or 
every other day, an occasional but regular walk, chewing the food, 
gymnastic training, all consume too much time. Dr. Gibbons observes 
truly of such: "They prefer physic to diet, regimen, ( xercise. " 



MEDICAL TREATMENT. 



DISEASES 

Described in Popular Language 

AKU 

CLASSIFIED 

ACCORDING TO MOST RECENT AUTHORS, 

WITH 

SENSIBLE -AND SCIENTIFIC METHODS OF CURE. 



Betriseb to mate. 



BY 

J. EDWIN DANELSON, M.D., 

Box 205, 
NEW YORK CITY. 



CLASS L-ZYMOTIC DISEASES. 

Order I. Miasmatic Diseases. 

" Other wars are towards death, but in this crusade THE WAR IS 
AGAIXST DEATHS 



ELEMENTS OF DISEASE. 
Irritation, Congestion, and Inflammation. 

Irritation is an excess of vital action not amounting to congestion 
or inflammation. It may arise from a condition of the blood or of 
the nerves, from excitement, as convulsions from worms, irritation 
of the brain from teething, coughing from dust, vomiting from preg- 
nancy, or from a condition of the system which predisposes to dis- 
ease, which we term diathesis, as in the scrofulous. 

Conge tion is an excess of bio d in a part with diminished motion. 
The veins are distended; there is numbness from diminished vitality 
and secretion is lessened. It may ce se of itself, or lead to inflam- 
mation. Suppurative effusion may fallow, or hemorrhage or dropsy. 
It is caused by mechanical obstructions, such as external pressure, 
constricting bands, disease of the heart, cancer of the liver, etc. ; by 
arrest of perspiration, by malaria and other agencies. 

Irritation is best managed by removing the cause or by the use of 
narcotics which decreases nervous sensibility. Congestion is treated 
230 



INFLAMMATION. 231 

by stimulants which restore the circulation, or by the vapor-bath 
which calls the blood to the surface. Cathartics and diuretics 
diminish the amount of blood by their action upon the bowels and 
kidneys. Nauseants relax the system, counter- irritation calls the 
blood to the surface, as a mustard plaster in pleurisy or congestion of 
the stomach. Blood-letting would be valuable were it not for its 
ultimate and disastrous consequences; binding the limbs near the 
body is more efficient and less injurious. The use of arterial se a- 
tives, such as veratrum viride, also curtails the supply of bl< od. 

To understand inflammation it is necessary to know that the blood 
consists in part of serum, inodorous and tasteless like water, minute 
little bodies called red corpuscles, which give it life and color and 
fibrin, a coagulable principle. Between the arteries and veins are 
little ve-sels called capillaries. The arteries force the blood into the 
veins because of their great contractile power, the vein cannot con- 
tract and holds it. This is congestion, the first stage of inflamma- 
tion. The capillaries are press d, the corpuscles adhere to their 
sides, the arteries are swollen, there is stoppage, the nerves are put 
upon the stretch and we have inflammation. The swelling and heat 
are caused by the increased amount of blood in the part, the red- 
ness from the number of red corpusch s and the pain from the pres- 
sure. Surrounding tissues are irritated and the inflammation spreads. 
Serum may ooze out, or blood itself, or fibrin. The latter becomes 
hard as in a boil. Decaying fibrin is pus or purulent matter; if it is 
withheld, abscess forms. The amount of swelling is controlled by 
the density of the part affected; the pi in depends upon the natural 
sensibility of the person, the distribution of nerves, as for example, 
whether on the finger or at its end, and the distensibility of the tissue. 
The nerves, however, perform their own function, and in inflamma- 
tion of the stomach the sensation is not pain but thirst. Every part 
has an instinctive sense subservient to the economy. A substance in 
the throat causes coughing, but in the lung gives no pain ; if it did, it 
w< uld interfere with an indispensible activity of life. If the thickening 
of the coats of the stomach from drinking alcoholic liquors caused pain, 



233 MEDICAL PRACTICE. 

we would have less intemp ranee. Inflammation induces fever vary- 
ing in degree upon the condition of the constitution, the age, the 
amount of inflammation and the organ <iff< cted. The fever is gen- 
erally high in pneumonia, low in felon, toothache, peritonitis, etc., 
and low and depressing after surgical operations. It produces death 
when the function of a vital organ is destroyed, when the blood is 
poisoned by the absorption of pus, and by exhausting the vital pow- 
ers. In mortification from freezing there is no inflammation; life is 
extinguished from the part at once. 

The treatment (if inflammation is a matter of the greatest impor- 
tance. Upon this rock the schools of medicine divide. No gen- 
eral rules can be given. In the pages which follow, the indications 
are given with each disease and their separate management. It will 
be noticed that frequent use is made of Veratrum Viride. This is an 
arterial sedative; it says to the heart so fast shalt thou go and no 
faster. With the pulse at one hundred or one hundred and forty, 
the inflamed brain or lung or other organ is almost flooded and over- 
whelmed with the irritating and destructive onset, But bring the 
number of beats down to seventy or eighty, the eye loses its glare, 
the skin its dryness, the body its heat, the tongue its fire and the 
head its throbbing pain. The inflammation, whether constitutional 
as in fever or local as in an organ or part, begins to abate. The pro- 
fession and people are greatly indebted to Dr. Norwood who brought 
this remedy into prominence. Twenty years ago arterial sedatives 
were almost unknown, now they are used by all the advanced practi- 
tioners of the leading schools. Just here we wish to "express our obli- 
gations to Dr. P. W. Allen, who made the not less important discov- 
ery that Veratrum is an antidote to blood-poisoning. A monument 
more lasting than that of bronze or marble will be erected to their 
memories. If I was denied all the drugs of the materia medica ex- 
cept one with which to treat acute diseases, inflammations and 
fevers, my choice would be Veratrum Viride, the tincture of the green 
root. Physicians complain that there are very few remedies that 
are positive in their action, but this is one of them. Its effects are 



BLEEDING. - 233 

more favorable in the robust of every age, but in feeble children or 
adults with deficient vitality I prefer and use Aconite. This ex- 
ception must be observed in consulting the pages that follow. 

It may be objected that Veratrum is a poison. The objection is 
faultj% for the same argument would apply to almost all of our most 
valuable drugs, such as morphine, belladonna, strychnine, the acids, 
Fowler's solution of arsenic and other minerals. Besides we always 
give it with a stimulant, generally oil of wintergreen. The essential 
oils are stimulants to the solar plexus, located near the stomach and 
one of the most important and influential in the body. Cases of 
poisoning must be rare, for we have not been able to find one in medi- 
cal literature or hear of but one by inquiry of many physicians who 
use it extensively. 

Bleeding, Loss op Blood, Hemorrhage. EcemorrJiagia. 

We understand by hemorrhage blood escaping from the arteries or 
veins. It may flow outwards as in cuts and wounds, or inwards as 
in blood-vessels ruptured from weakness by disease or from straining. 
That blood that pours from an internal vessel may find its way out 
of the body. This is seen in bleeding of the lungs, in bleeding into 
the stomach which is vomited, in bleeding of the kidney which is 
voided with the urine, and in piles and dysentery where it is expelled 
from the bowels. Uterine hemorrhage is of this nature. If it can- 
not escape it collects in some of the cavities, chiefly the chest and 
abdomen: in apoplexy it passes into the brain substance but cannot 
find exit. Some make a class of active hemorrhages, such as nose- 
bleed from a determination of blood to the head ; and passive, the 
oozing with debility. Surgeons speak of secondary hemorrhage, a 
dangerous loss of blood following a few days after an operation or a 
lacerated wound. 

treatment. 

As the management of hemorrhage is given with the sketch of 
each disease in which it occurs only excerpts and general hints are 



234 • MEDICAL PRACTICE. 

here presented. A good internal remedy and the most reliable for 
general purposes is 

3. — Tincture of Fleabane, 

Tine Lure of Cinnamon, m equal parts. 

Mix. 
It may be given in five-drop doses on sugar, or in sweetened 
water every hour, or more frequently if necessary. Heat stops 
bleeding and at the same time resuscitates when the hemor- 
rnage is excessive. In desperate cases where the face is pallid 
and brain bloodless from severe loss, apply to the head the 
hot compress by the rubber-bag or by a bag of heated salt 
or sand! Bleeding from the lungs, womb or bowels may be 
stopped by drinking hot water, by hot water injections and by the 
spirit vapor bath. Absolute rest as far as it can be observed is 
necessa:y. Table salt makes a ready remedy in Jung hemorrhage. 
For external wound*, or in nose-bleed, piles, and the like, there is 
powdered burnt cork, powdered alum, cinnamon, tannin and presul- 
phate of iron. These can be used in powder form, and most of 
them in solution. The iron in water is the sheet-anchor in danger- 
ous dysentery. From injuries a large artery may be severed, which 
must be tied in the manner described under the subject of Wounds, 
to which the reader, if interested in the subject, is referred. 



FEVERS. 



FE VERS. —Pyrexia. 

If it has not already been discovered that I have little to say of the 
theories of diseases, such has been my intention. In relation to 
fevers in general, however, views differ widely, some believing that a 
poison has been introduced which, to save life, must necessarily be 
expelled; others, that the symptoms of fever are but the manifesta- 
tions of an internal ferment, which, if the vitality is sufficient, will 
in due time run its course and the patient survive; by others, that all 
symptoms presented are efforts on the part of nature for the removal 
of blood-poison and its obstructions from the system. 

All admit that the presence of morbid matter in the system pro- 
duces fever. As like produces like, can we expect a morbid state to 
produce a healthy action? 

On the other hand, if fever is a healthy effort of nature to throw 
off disease, it follows that fever will produce healthy results. But 
the stronger the effort, and the longer the fever runs, the more de- 
structive is its power. Compare a healthy increase of the circula- 
tion of the b'ood with fever. A healthy man exercises freely; per- 
spiration is copious; all the evacuations of th<; body are open; the 
man has a good appetite for his food; dkestion is promoted; he 
sleeps well, and is strengthened by the exercise. 

In fever, however, the evacuations are generally closed; the skin 
is dry; the tongue coated; the appetite gone; and the patient is rest- 
less and reduced in strength. 

If, in the course of a fever, the evacuations are open, and morbid 
matter is excreted freely, it is when the fever is so reduced as to al- 
low nature to perform this healthy work. Let it be understood that 
the healthy work of eliminating effete matter from the system is 
closed by fever, and also that the r;ipid increase of the circulation 
brings the blood too frequently in contact wiih the oxygen of the air 
we breathe, thus increasing the heat, drying up the fluids and for 



236 MEDICAL PRACTICE. 

the time being suspending digestion, secretion, assimilation and ex- 
cretion. Now, let the fever run high and continue long enough, 
and death is the result. 

The human system is never so able to throw off effete matter, 
never so strong to resist the incroachments of disease, as when there 
is an equilibrium throughout the whole body. In our normal con- 
dition there is an equilibrium between retention and excretion, be- 
tween wet and dry, heat and cold. In these and many other cases, 
fever destroys our equilibrium. As this general derangement of the 
system is caused directly by fever, with no evidence of good results, 
it seems very inconsistent to call fever a healthy effort of nature to 
throw off disease. Vitality is, indeed, in opposition to disease. 
But how does vitality manifest itself? The blood is passive, and 
only active as it is acted upon. There is no evidence that the blood 
rushes through the system, or any part of it, to make any attack 
upon disease. In a bealihy state the blood silently and regularly 
goes the rounds of the circulation to warm and nourish the body. 
Suspension, pervertion or interruption of any function of vitality, at 
once produces, or is itself, disease. Fever and inflammation are 
irritated conditions. Inflammation is generally local fever. Let a 
healthy man receive a cut, say upon his hand. Now, if the parts of 
the flesh can be put together as they were before, and so quick that 
no blood is thrown out of its course, the wound will heal without 
inflammation. But, as this is next to impossible, the severed veins 
and wound will produce some stoppage of the blood. As soon as a 
portion of blood becomes stagnant, it loses at least a part of its 
vitality, and the capillary circulation is interrupted. The blood, in 
its regular circulation, comes up to the stagnant blood and stops, 
not like a lot of boys who stop to witness a dog fight, and then run 
voluntarily away, but, being passive, it is interrupted in its course, 
and turns in with the stagnant mass, and thus w r e have inflammation. 

Iu general fever the morbid matter has entered into the general 
circulation, and is not stopped at one place, but, being a foreign and 
obtrusive substance, it is the cause of irritation. The motor nerves, 



FEVERS. 237 

thus irritated, ?,re brought into more active play, and we have 
fever. In the cut and inflammation there is a pressure upon sensi- 
tive nerves, producing pain. In general fever, heat, friction and 
pressure affect the sensitive nerves so that 'there is great uneasiness 
and headache How perfectly absurd is it to suppose that the blood 
makes an extra effort and sets up a gallop to drive morbid matter 
out of the system, and yet, not only fails in the attempt, but cioses 
all the doors and aids to convert the remaining pure blood into 
poison. What seems more strange than this is, that the same men 
who contend tiat fever is a healthy action of the blood, should give 
directions to break up a fever and not allow it to run its health-pro- 
ducing course. Yet, the cou ; se recommended and the most success- 
ful treatment followed is, to reduce the fever by sedatives and by 
diaphoretics and by other eliminatives to remove the offending 
cause. Nor can we hope for convalescence until we have mastered 
the fever. Nor can the morbid matter be eliminated from the sys- 
tem until the fever subsides. 

It follows therefore that fever is a disease, that the equilibrium is 
disturbed, that the natural evacuations are closed and that the most 
successful treatment is that which will break it up by antidoting the 
poison, opening the emunctories and restoring the equilibrium. In 
fact breaking it up, is only another term for removing the disease 
and saving as great an amount of vitality as possible. 

In discussing the different types of fever we shall endeavor in each 
instance to notice the conditions which require special attention, and 
the best means of meeting them. 



MEDICAL PRACTICE. 



DISINFECTANTS. 

Directions fou Preventing the Spread of Infectious Dis- 
eases: Small -Pox, Scarlet Fever, Measles, Typhus Fever, Typhoid 
or Gastric Fever, Whooping-Cough, Diphtheria, etc. (Maclagan.) 

I — 1. lactate the person affected as much as possible from the oilier 
inmates of tlie house. 

This is most readily effected by at once removing him to an upper 
room, if circumstances permit. The room selected should be large 
and airy, and the means of ventilating it, which shall be presently 
mentioned, at once adopted. 

2. Before removing the patient, all superfluous curtains, carpets, 
woollen articles, unnecessary clothing, in short, everything likely to retain 
infection, should be at once removed. 

3. The patient's bed ought to be so placed as to allow of a free cur- 
rent of air around it, but not so as to place it in a draught. 

4. The room must be kept icell ventilated, under the physician's 
directions, by means either of a fire (when required), or of an open 
fire-place and chimney and of windows open to the external air. 
By means of the latter, ventilation is most effectually procured so as 
to avoid draughts, in the following manner: 

Raise the lower sash of the window three or four inches, then procure 
a piece of wood to fit accurately into the lower opening, and place it there. 
By these means free outward and inward currents of air — without 
causing ;my draughts — are obtained through the vacant space between 
the two ^ ashes. Wlien a window is merely opened from tlie upper or 
low r tash, draughts are invariably caused. 

5. Placing a small sheet of oil -cloth, mackintosh, or other water- 
proof material, beneath the upper blanket on which the patient is to 
ret effectually prevents the bed from being soiled by any dis- 
charges, etc. 



DISINFECTION. 239 

II. 1. After removal of the patient to the room in which he is to 
remain, the outside of the door and door-posis should be completely 
covered by a sheet kept constantly wetted with some disinfecting 
fluid, such as carbolic acid, etc. 

2. The room must be kept scrupulously clean. Before being 
swept, which should be done daily, if possible, the floor should be 
sprinkled with a weak solution of the disinfecting fluid. 

3. Vessels containing disinfecting fluids should be placed in the 
room for the reception of all bed and body linen, towels, handker- 
chiefs, etc., immediately on being removed from the patient, and on 
no account should they be washed along with other household 
articles. 

4. Disinfectants should also be placed in all the chamber utemils 
used by the patient, and, after use, more disinfecting fluid should be 
added and the whole contents, if possible, should be immediately 
buried. No chamber vessel should be allowed to remain in the room after 
having been used. 

5. All plates, cups, glasses, etc., which have been used by the 
patient, should be rinsed with some disinfectant before being washed; 
and on no account should any vessels used in the sick room be 
washed along with other things, unless previously thoroughly disin- 
fected. 

6. Attendants on the sick should not wear woollen dresses, but 
only those made of washing materials. 

7. Basins containing water, to which some disinfectant has been 
added, should always be at hand for the benefit of the attendants on 
the sick, who should not be sparing of their use. 

8. No article of food or drink from the sick room should be con- 
sumed by other persons. 

9. Visitors to the sick room, except in the case of clergymen and 
medical men, should be peremptorily forbidden ; and they, when 
necessarily present, should, on leaving, wash their hands in water to 
which a disinfectant has been added, and should have as little imme- 
diate communication with others as possible. 



240 MEDICAL PRACTICE. 

III. 1. When a death from infectious disease occurs, the body 
should be at once placed in a coffin and sprinkled with some disin- 
fecting fluid or powder, such as chloride of lime, etc., and buried with 
the leant possible delay. 

2. On no account whatever should it be allowed to remain in a room 
occupied by living persons. 

IV. 1. On the termination of a case of infectious disease, either 
when the patient is pronounced free from infection, or, in the event of 
death, after removal of the body, the sick room and its contents should 
be thoroughly cleansed and disinfected. 

2. The bed and bed-clothes, and all wearing apparel used by the 
attendants or patient, should be Jwroughly disinfected. 

V. — 1. In houses where a case of infectious disease occurs, no 
washing, tailoring, dressmaking, nor any similar occupation, ought to 
be carried on. 

2. No milk or food of any kind should be supplied from the in- 
fected house. 

3. Children from infected houses should not be allowed to attend 
schools, and all persons from infected houses should have as little 
communication as possible with others either in private liouses or in 
public places, such as railways, omnibuses, public-houses, churches, etc. 

4. Any accumulation of tilth or refuse of any kind should be at 
once removed from or about the premises, and disinfectants freely used. 

VI. — 1. During the prevalence of epidemic, infectious or contagious 
diseases, it becomes specially important that the general laws regard- 
ing the preservation of health should be rigidly attended to. 

2. Implicit trust should not be placed in so-called " disinfectants:'' 
They are very useful when judiciously employed, but are by no 
means certain " preventives of disease." 

3. Pure air, pure water, warm clothing and good food should always 
be obtained if possible. By their constant use less chance is afforded 
for an invasion of disease. 

4. Temperance both in eating and drinking is essential for the 
maintenance of health and the prevention of disease. 



INTERMITTENT FEVER. 241 

5. Overcrowding in houses, workshops or schools should be 
strictly prohibited. 

6. All houses cottages, schools and public rooms, should be kept 
clean and well ventilated ; and frequent use of lime-washing on the 
walls and ceilings should be made. 

HOW TO DISINFECT ROOMS. FUMIGATION. 

R oms which have been occupied by a person suffering from 
infectious disease should, on the termination of illness, be at once 
disinfected. To effect this thoroughly, all crevices around windows 
and doors and the fireplace should be closed by pasting pieces of 
paper over them. Lumps of sulphur (brimstone), one pound for 
every cubic foot of space, should then be put into a metal dish, 
placed by means of tongs over a bucket of water. This being set 
fire to, the doors should be closed, and the room should be allowed 
to remain without interference for three or four hours. After this 
time the windows should be thrown open, and when the fumes have 
disappeared, all the woodwork and walls should be thoroughly- 
washed with soft soap and water, to which carbolic acid has been 
added (one pint of the common liquid to three or four gallons of 
water), and the paper from the walls stripped off. In whitewashed 
rooms the walls should be scraped, and then washed with hot lime, 
to which carbolic acid has been added. The windows should then 
be kept open for thirty-six or forty-eight hours. 

Intermittent Fever, Chills and Fever, Ague, Dumb Ague. 

This fever and the one immediately following are typical of all 
malarial fevers. Physicians divide it into stages; chill, fever, and 
sweat. The chill is decided and irresistible. The skin becomes bluish 
or purplish, and is shrunken, having the appearance commonly 
known as goose-flesh. The whole frame shakes ; the teeth chatter ; 
there is restlessness with headache, thirst and loss of appetite. The 
agitation may be so great as to impart a trembling motion to the bed * 
or lounge on which the person lies. Feeling a draught or a finger- 
11 



242 MEDICAL PRACTICE. 

touch increases the rigor. This continues for half an hour, and some- 
times a full hour, but is seldom of so long duration. As this ceases, 
the feverish stage appears. The surface becomes heated, the head- 
ache intensified, the pulse more rapid, the ihroat and tongue dry, the 
urine scanty and bowels constipated. This period may last for 
hears; and its duration, coupled with the bodily heat as indicated by 
the thermometer is prognostic of the severity of the attack. As the 
fever abates, which it does of its own accord, and as the secretions 
are unlocked, the sweating stage advances; moisture appearing first 
upon the f:ice and afterward upon the body, occasionally being most 
profuse. These stages constitute a paroxysm and. uninfluenced by 
medication, follow each other with marked regularity. There is 
usually a period of comparative freedom from all symptoms of the 
disease between the third stage and the recurrence of the first. 

The paroxysm may occur twice in one day, daily, or every other 
day; the list two being most common. Rarely we have paroxysms 
on the first and third, first and fourth, first and fifth day, and so on. 

The variety of intermittents is so great that occasionally it is diffi- 
cult of detection by the physician. We may have the chill without 
any marked fever or sweat; the regularly appearing fever without 
any marked chill ; or fever and sweat with only the slightest chilly 
sensations. This latter is popularly known as dumb ague. Still it 
will be noticed that with some regularity some signs of the stages 
appear daily, or more commonly every other day. Iu malarious dis- 
tricts pei*ioditity is not only a mark of fever, but of other diseases, 
particularly those dependent upon congestion. Pernicious fever is a 
malignant and epidemic intermittent. 

It is distinguished from other diseases without much difficulty. A 
chill with headache, vomiting, etc., may occur at the outset of many 
diseases, but the other symptoms that may be present facilitate the 
classification. Forty-eight hours' time will in most cases confirm the 
diagnosis. In wasting diseases, such as consumption, we have a re- 
curring flush termed hectic, but this is unattended with headache 
and falling temperature; is less regular; and the chronic local diffl- 



INTERMITTENT FEVER. 243 

culty is so well marked that one cannot be easily misled. Deep- 
seated abscesses, while forming, are also combined with periodical 
chills and hectic, but the localized pain, or an examination of the 
larger organs — particularly the liver and lungs — will discover the 
real malady. 

The indication* are to relieve at once the stage in which the pa- 
tient is suffering, to stop the fever, break up the periodicity, to re- 
lieve congestion of the liver, spleen and kidneys, and to neutralize 
and expel the malarial poison in the blood. 

TREATMENT. 

The chills in the cold stage may be relieved by giving — 
1$. — Chloroform, .... one dram, 

Comp. Spirits of Lavender, . . one ounce. 

Mix. 

Put a teaspoonful in one or two of water, and give every ten or 

fifteen minutes. 

If the patient is insensible, use instead of the above a decoction or 

tea of lobelia and capsicum. When partly cooled inject a few ounces 

into the bowels. Combine the use of the above with the spirit-bath 

by means of the rubber bag, filling it with hot water and sprinkling 

with alcohol. 

For vomiting, particularly if it inclines to be persistent, use in 

teaspoonful doses every hour : 

1$. — Fluid Extract of Rhubarb, . one dram, 

Brandy, two drams, 

Essence of Spearmint, . . thirty drops, 

Bicarbonate of Soda, . . one dram, 

Simple Syrup, . . . four ounces. 

Mix. 

An additional means may be employed, consisting of a sinapism 
made of one-third pulverized mustard and two-thirds pulverized 
ginger mixed with cold water, spread on a cloth and applied over 
the stomach. 

Carefully avoid exposure in the sweating stage. To meet the re- 



244 



MEDICAL PRACTICE. 



maining indications quinia in some form h desirable. Quinia is the 
great anti-periodic. Its discovery gave to humanity one of its 
greatest boons. Take — 

^. — Sulphate of Quinia, . . twenty grains, 
Tannic acid, . . . fifteen grains, 

Pepermint water, . . . one ounce, 
Cinnamon, "... one ounce, 
Simple Syrup, . . . two ounces. 

Mix. 
Give a teaspoonful every two or three hours. To an adult, or 
when a pill can be easily swallowed, it is better to give— 



twenty-four grains, 
two grains, 
twelve grains, 
in sufficient quantity. 
Give one every two or three 



I£. — Sulphate of Quinia, 
Podophyllin, 
Capsicum, 
Extract Licorice, . 
Mix and make twenty-four pills. 
hours. 

To act on the kidneys, alternate with one of the above, giving a 
teaspoonful one hour after each dose, of the following : 

I£. — Spirits of Nitre, . . . three drams, 

Acetate of Potash, . . . two drams, . 
Tincture Colchicum Seeds, . half an ounce, 

Water, three ounces, 

Essence Wintergreen, . . one dram. 

Mix. 
In persons of nervous habit Quinia may be given in the hands. 
First wash the hands thoroughly in warm water, and when partially 
dried, place in the palm ten grains and moisten with water. Rub 
with the finger-ends or opposite palm for ten minutes or until tasted. 
For young children mix one dram with one ounce of lard and rub 
the abdomen with a portion. It will thus be absorbed. 

For dumb ague, and to be used by those living in malarial dis- 
tricts, we strongly recommend the occasional administration of the 
following pill : 



REMITTENT FEVER. 245 

3.— Podophyllin, . . . .-•■-. six grains, 

Leptandrin, .... twelve grains, 

Iridin, two grains, 

Extract of Dandelion, . . q. s. 

Mix and make twenty four pills. Take one each night and morn- 
ing. 

Remittent Fever, Miasmatic or Malarial Fever, Bilious 
Fever. 

Like the previously described fever, this also has three stages, and is 
notable for its periodicity. The principle features are exacerbation and 
remission; that is, the regularity in the increase and decrease of the 
fever. It begins with a slight chill attended with sickness at the 
stomach, headache, pain in the limbs, some thirst and commonly nau- 
sea or vomiting. These symptoms are soon followed by high fever, 
the pulse rising rapidly, the temperature increasing, with restless- 
ness, increased headacho, and pain in the back and limbs, nausea or 
vomiting, and disgust for food. The urine is scanty and high- 
colored, and the bowels closed. This fever runs its course in from 
six to ten hours, and then gradually subsides. With this remission 
all the symptoms decrease in severity. The skin may become moist 
and the patient sleep. The day following the attack, or more com- 
monly on the second da3 r , the pulse is again accelerated, the fever 
increased and all the symptoms aggravated, to be again followed by 
abatement. In this fever there is no interval of complete freedom 
as in the preceding variety. There is constantly present some ache 
or fullness of the head, some coating of the tongue, some distress of 
the stomach, and the biliary disorder commonly shows itself in ting- 
ing the eye-ball and skin yellow to a greater or less extent. The chill 
seldom reappears, the first being the only one. 

It is distinguisTiedfrom intermittent fever in the manner above in- 
dicated. It can hardly be confounded with other fevers which pre- 
sent many of the symptoms belonging to the respective groups. 



246 MEDICAL PRACTICE. 

Tlie indications are to relieve the congestion of the liver and ab- 
dominal viscera, to reduce the fever, to tone the liver and thus obvi- 
ate bilious congestion, and to sustain the general strength, partic- 
ularly if typhoid conditions appear. 

TREATMENT. 

We know no better method of meeting the first than by the use of 
lobelia in tincture or decoction until free emesis follows. In weak 
systems, however, a mixture of a teaspoonful each of table-salt and 
mustard with a tumblerful of warm water is preferable. In the first 
stages of the disease, before the coats of the stomach and bowels are 
involved, and especially if the liver is enlarged, a cathartic may be 
used with advantage. We like an herb-tea composed of senna, jalap 
and spearmint, or a pill made of 

~B,. — Sulphate of Quinia, . . twenty-four grains, 
Podopliyllin, . . . two grains, 

Capsicum, . . . twelve grains. 

Mix. 

Make twenty-four pills. Give one every hour until the first move- 
ment of the bowels ; then stop this and of course all cathartics. To 
reduce the fever — 

1^. — Tincture Yeratrum Viride, . twenty or thirty drops, 

Water, .... eight teaspoonfuls. 

Mix and take a teaspoonful every three or four hours. Or take — 
1$. — Tincture Aconite, . . fifteen drops, 

Water, .... half a tumblerful. 

Mix and give a teaspoonful every two hours. Bathe the body with 
warm water, to which is added a little alcohol. 

To meet the third indication we advise the use of — 

If.— Leptandrin, . . . twenty grains, 

Ilydrastin, . . . ten grains, 

Sulphate of Quinia, . . twenty grains. 

Mix. 

This will make ten doses and may be eriven in the powder with 



TYPHOID FEVER. 247 

fruit, syrup or jelly, or may be made into twenty pills and given two 
at a dose. Take a dose every four hours. This recipe is specially 
useful and effective when the skin is moist and the pulse does not 
heat over eighty-five a minute. 

To strengthen the system when the fever has partly subsided, or 
t® preserve the strength should typhoid symptoms appear, we make 
use of the best nerve and muscular tonics known in the materia 
medica. The?e, howeve", are not employed until there seems to be 
no further need of the veratrum or aconite and the capsicum or hy- 
drastin pill. In one tumbler mix 

Dil. Phosphoric acid,. . thirty drops, ' 
"Water, .... two or three ounces, 
And give a teaspoonful every two hours. In a second tumbler 

mix — 

Tinct. Nux Vomica, . . ten drops, 

Water, ... . . two ounces, 

And give a teaspoonful one hour after each dose of the above. 

If other symptoms and indications arise that closely resemble a 
low grade of fever, they may be treated as advised in the essay upon 
typhoid fever. 

Typhoid Fever. 

This is also known by the names of nervous fever, abdominal fever 
and enteric fever. The old and young are generally exempt; the 
middle aged in either sex are the principal sufferers. It may attack 
but a single person in a locality or it may attack many, becoming 
epidemic. By most medical authors it is not considered contagious. 
It is caused principally by the introduction of animal and vegetable 
poisons. These causes have been considered at length in expound- 
ing hygiene, particularly while upon the subject of water, drains, etc. 

Symptoms. — At the outset the invalid is only aware of mental and 
physical oppression, languor, sometimes headache, impairment of 
appetite, and a careworn expression of countenance. As this failing 
of the nervous energies continues, there are alternate flushes of heat 



248 ' MEDICAL PRACTICE. 

and chilliness, and sometimes a distinct chill. Fever now sets in and 
the patient is compelled to take to bed. Within a few days the fever 
can be dist : nguished without difficulty. There is increased head- 
ache, disgust for food, thirst, hot skin increasing one or two degrees 
by night, tenderness of the abdomen, particularly in its lower part 
on the right side near the pelvis bone, or, in other words, in the re- 
gion of the juncture of the ilium and caecum, flatulence, abdomen 
returning a hollow and drum-like sound to the tap of the finger end, 
offensive diarrhoea of a dark brown or yellow color, and an eruption 
resembling flea-bites upon the chest. From the second to the third 
week all the symptoms increase in intensity, the pulse is more rapid, 
the heat reaching one hundred and three or one hundred and four 
degrees or more, the thirst is extreme, the diarrhoea more frequent, 
thick crusts appear upon the tongue and gums. The invalid is semi- 
conscious and sometimes delirious, has great restlessness through the 
night, the urine and stools mny escape involuntarily, with incoherent 
muttering and either perfect quiet and indifference to surroundings, 
or restlessness displayed in mental agitation, throwing the hands 
about, removing the bed-clothes, and sometimes leaving the bed sud- 
denly when rot able to stand upon the feet. Between the third and 
fourth week occurs what is denominated the crisis; a change for the 
better or worse. In some cases the fever may linger some two or 
three months without any very marked change. With proper care 
and attention most cases will be well and attending to their avoca- 
tion before the twenty-first or critical day arrives. 

Care should be exercised in distinguishing the fever from typhoid 
conditions. There arc debilitating diseases that may present many 
of the symptoms of this malady but having prominent features of 
their own. For instance, general debility is too slow in its develop- 
ment, delirium is absent and the tenderness of the bowels ; in inflam- 
mation of the bowels pain is local, delirium and the flea-bite erup- 
tion are absent; in diseases of the lungs there is the absence of the 
bowel and the head symptoms; Bright's disease is known by urinary 
sediments. 



TYPHOID FEVER. 249 

The indications are to determine to the surface, lower the tempera- 
ture, overcome brain symptoms and tendency to the head and relieve 
inflammation of the bowels and diarrhoea, should they occur. Simple 
but adequate nourishment is also demanded. 

TREATMENT. 

First, general method. In a majority of cases an acid seems 
indicated and the successes attending its administration fully 
warrant its use. Dilute hydrochloric acid may be given in doses 
of from six to fifteen drops every four or five hours, or dilute 
nitro-muriatic acid in doses from ten to twenty drops every two to 
four hours. These may be given in a tablespoonful of sweetened 
water or of slippery-elm tea. Milk, or beef tea or both, may be 
given, between each dose. An alcohol and warm water sponge-bath 
two or three times in twenty- four hours, is of advantage, and may 
be used more frequently if a high temperature is indicated by the 
thermometer. It is reported that during the Franco-Prussian war the 
Germans immersed their comrades affected with the fever in cold 
water and then wrapped them in wet sheets. Its administration in 
the evening will often secure refreshing sleep. Cathartics are of 
avail only at the outset ; afterward they are dangerous. Calcined 
magnesia is the best by far. 

Tincture of belladonna, ten drops in half a tumbler of water, will 
relieve brain congestion, headache, tendency to delirium, dull and 
heavy expression of the eyes and countenance, and painful suscepti- 
bility to noise. Cloths wrung out of cold water may be applied to the 
head at the same time, changing them as rapidly as they become the 
least warm, and heat by the rubber bag to the feet. 

Tenderness and rumbling in the bowels may be relieved by a hot 
pack, sprinkling upon ihe surface coming next to the skin the spirits 
of camphor or equal parts of tinctures of aconite and arnica. These 
act more speedily if a decoction of lobelia herb is substituted in 
place of water. It is an excellent relaxant and lowers the tempera- 
ture indirectly by causing perspiration. 

In case of hemorrhage of the bowels apply the cold pack and give 
11* 






250 MEDICAL PRACTICE. 



internally tincture of hamamelis in four drop doses, every three hours. 
Diarrhoea may be stopped by powders composed of kino and leptan- 
drin, one-half grain of each, every three or four hours. 

Upon the subject of diet, Dr. Gardner says: " You must fee 1 your 
patients, and feed them chiefly on m ; lk; milk or buttermilk, is with 
me the staple food, and I will even say I know no other food that 
can be depended upon. 

To give wine, whisky, or bef-tea, while withholding milk, is sim-* 
ply to destroy your patient, and the more wine or whisky you give 
while withholding milk, the more sure you fire to destroy your 
patient, because you are thereby superseding the natural appetite (or 
what remains of it) for a nourishing and wholesome diet, by a diet, 
if it can be so called, which poisons the blood." 

Contagion and Disinfection. 

The mode in which infection is chiefly spread in this disease is by 
the poison contained in discharges from the patient's bowels, and 
lasts certainly as long as these discharges continue to be unnatural. 
It is believed, however, by some, that this disease is infectious in 
other ways. These discharges infect the surrounding air, the bed 
and body linen, and also all places used for their reception. Thus, 
if placed in a water-closet, ctsspool, privy or ashpit, the sewers i f a 
town or village, and through them the drains of houses, may, under 
certain circumstances, be the means of disseminating the disease. 
When drains into which these discharges have been thrown pass near 
to wells, the water in the latter has frequently been found to be per- 
fectly unfit, indeed dangerous to use. By f-ulty construction of such 
drains, soakage is frequently caused either into wells or into the sur- 
rounding ground, rendering them directly the means of spreading 
the disease. Cisterns may become contaminated by having their 
overflow pipes terminating in drains; and even water supplied by a 
water company may become infected by gas being drawn into defec- 
tive pipes during an intermittent supply. 

Milk has frequently been found to be a fruitful medium for con 



DISINFECTION OF TYPHOID. 251 

vey'.ng the disease, either from having been placed in infected air, 
from which it has absorbed the poison, or from milk-pails having 
been washed, or the milk adulterated with water containing the in- 
fection. Great care should therefore be taken as to the source of the 
household milk supply. 

The most certain and most deadly manner in which the poison of 
typhoid fever is conveyed is by contaminated drinking water. The 
most certain way of preventing this contamination of water is by 
immediately destroying the poison contained in the discharges as 
soon r.s th< y are passed by the patient. 

Disinfectants should be placed in the chamber utensil before use; 
and immediately after being used more disinfectant should be added. 
Above all things, the use of disinfectants should be frequent and 
copious. The patient ought also to expectorate into a vessel con- 
taining some disinfectant. 

All sheets, towels, handkerchiefs, etc., which have been used by 
the patient, should be thoroughly disinfected and afterwards care- 
fully washed. 

In all cases of infectious disease, it may be well that the patient 
use rags or pieces of old linen, etc. , (in lieu of pocket handkerchiefs), 
which may afterwards be burned. 

When the bed or body linen is soiled, the soiled spots should be 
sprinkled with some disinfecting powder. 

A small sheet of gutta-percha, mackintosh cloth, or other water- 
proof sheeting, placed below the upper blanket under the patient's 
body, effectually protects the bed from discharges and is especially 
useful in this disease. 

After the performance of any duty about a patient, the attendants 
should wash their hands freely in disinfected water. 

The discharges should never (if it can possibly be avoided), be 
placed in a privy or water-eloset, but should, after complete disinfec- 
tion, be buried dt epiy in the ground at a distance from any drain, 
well, or watercourse. On no account should they be thrown on any 
ashpit or dunghill, nor into any cesspool. — (J. M. Maclagan, M.D.) 



252 MEDICAL PRACTICE. 

Typhus Fever. 

It is known by various names arising from its peculiar symptoms or 
from the locality where it appears. It has been called contag ous 
typhus, brain, malignant, putrid or petechial fever, or hospital, jail 
or ship fever. The symptoms in its earlier stages are similar to 
typhoid. It will run its course, however, with greater rapidity and, 
in most cases, terminates in the brief period of two weeks. The 
brain and nervous system are principally involved and at an early 
stage we have excessive muscular weakness. This is eminently a 
filth disease and prevails but seldom in villages and the country and 
among well-fed, clothed and washed communities. It is highly con- 
tagious and generally epidemic. 

It is distinguished from typhoid fever by the suddenness of the 
attack, the great weakness and prostration, the burning heat of the 
skin, the flushed face, the tendency to stupor sometimes from the 
beginning, constipation, the rash, dark-colored, covering the whole 
body and the more depraved,. dusky, and liquid blood. In typhoid, 
the fever developes more slowly, the loss of flesh is greater, diarrhoea 
usually sets in, the face is pale and there are the abdomiual symp- 
toms. 

TREATMENT. 

The indications are to lower the pulse, reduce the heat, arouse 
the liver and spleen, and overcome the stupor and congestion 
of the brain and spinal centres. If the pulse is strong and 
full, give veratrum in two or three drop doses every two or three 
hours. To remove the heat frequent sponge bathing with warm 
water is necessary. Attention to the liver and spleen by the ad- 
ministration of 

fy— Leptandrin, .... one grain, 

Podophyllin, . . . one-eighth grain, 
Ext. Hyoscyamus, . . . one-half grain. 

Mix. 
Or a combination of podophyllin and cream of tartar^ thoroughly 



CONGESTIVE FEVER. 253 

mixed, may be employed. Either may be administered every four 
hours until free evacuations ensue. The manifestations demanding 
the greatest care and attention is the stupor or tendency to stupor 
and cerebral congestion. As you value life avoid the use of opium, 
morphine, quinia and like remedies whose chief tendency is toward 
the brain ; invading and overwhelming it. Here the disease has a 
similar bent or inclination and needs the bit rather than the spur. 

Belladonna in drop doses should be alternated with the veratrum 
or, if there is sleeplessness and muttering delirium give 

1$. — Fid. ext. Gelseminum , . , thirty drops, 
Fid. ext. Belladonna, . . fifteen drops, 
Water, » . ... half a teaspoonful. 

Mix. 

Give one hour or one hour and a half after each dose of veratrum. 
If the veins about the neck and head are greatly distended, tight 
bands may be passed around the extremities close to. the body, re- 
moving one at a time and at intervals as the beats of the pulse lessen 
in frequency. 

Congestive Fever— Pernicious Fever. 

It is more commonly known by the former title. Sometimes it is 
termed pernicious, and, in fact, closely resembles it in fatal cases. 
It is a powerful, poisonous and destructive disease, but is confined 
to the hotter climates, — to the southern and southwestern states of 
the United States. The disease is congestive because there is a ten- 
dency to the congestion of the liver, spleen, lungs, or brain. The 
attack is usually sudden, but not alarming in most cases. There is 
a chill, usually severe nausea and vomiting, thin discharges from 
the bowels sometimes mixed with blood, and intense thirst. When 
the brain is congested unconsciousness or delirium may be present. 
In congestion of the abdominal organs pressure not only induces 
local pain, but pain is felt in every part of the body. If the lungs are 
involved, breathing may be attended with great difficulty. There 



254 MEDICAL PRACTICE. 

is a palsied action of the functions of the organs involved, and the 
impression of the poison is so depressing that, in some cases, it kills 
at once. Not only is there a change in the character of the circula- 
tion, but we have also a change in the character of the blood itself. 
The nervous system is powerfully involved, including as it does, 
the nerves of organic life. There is a class to which the term 
" cold" is applied. Then we have the capillaries involved. There 
is coldness of the surface, paleness of the face, shrunken features. 
The extremities are chilly, cold, and have a damp sweat. 

It is distinguished from other fevers by its suddenness and sever- 
ity. At the outset it may resemble the intermittent or remittent 
fever, but in a few hours severe prostration proclaims its true nature. 

The indications for treatment, though difficult to be met, are two 
in number : to relieve the congestion, and to eliminate the blood- 
poison. 

TREATMENT. 

If the conge=tion can be overcome promptly, the patient is 
safe, and not otherwise. Reliance should be placed chiefly upon 
the employment of heat and the use of cayenne pepper in de- 
coction, both externally and internally. Cloths wrung out of hot 
water should be applied to the abdomen, and frequently renewed. 
The whole body should be frequently bathed with the same. If the 
lungs or brain are involved, injections into the bowel of a weak 
solution should be administered every half hour or hour. The in- 
tense thirst will disappear as the fever subsides. Drinking but adds 
to the irritability of the stomach. If the brain is involved, in addi- 
tion to o her treatment the extremities should be bound near the 
body by tight cords or bands. By this means, even in a few min- 
utes, the veins begin to enlarge and confining the blood keeps just 
so much of it from the head. Mustard paste may be applied to the 
feet if thought best. 

To destroy the malarial poison give sulphate of quinia and capsi- 
cum (ciyenne pepper) in pill f..rm, in quantities of one grain each, 
mixed, for a dose. The quinia is the purest anti-malarial remedy 



YELLOW FLVER. 255 

we possess, and the capsicum is the simplest and most effective 
stimulant. Besides, combining one with the other we escape the 
unpleasant symptoms due to overdosing with quinine. 

Yellow Fever, Black Vomit, Yellow Jack. 

This is a disease of the hot climates and prevails in the hottest 
weather. It seems to be contagious and malarious, but begins always 
in cities where filth is abundant and ihe heat excessive. New Orleans 
has been the c< ntre of diffusion more times than one. It has trav- 
eled up the Mississippi as far as Vicksburg and the Ohio to Memphis, 
has been found along the const, in {Savannah and Fernandina, and, 
in 1855, raged in Norfolk, Virginia. An isolated case has aj peared 
in later times in Philadelphia or Baltimore, and rarely in New York. 
Such cases, however, are usually of strangers and are believed to be 
those who have been smitten with the plague before their arrival. In 
cold weather the type of fever changes to that of remittent or 
typhoid. 

The premonitory symptoms do not differ from remittent, fever, but 
the affection is overwhelming and of short duration. There is usually 
a chill and pain in the limbs, back, stomach, liver and head, with 
quick pulse and hot skin. Fever rapidly follows and may last for 
two days. Thirst is intense, the stomach irritable, the bowels costive 
or discharges dark colored. The pain increases and < xtends in all 
directions. The nervous system is involved and not unfr. quently 
delirium is followed by stupor, coma and dissolution. 

Upon entering the second stage the fever subsides, the i ulse falls, 
and the yellowish color, which gives the characteristic name to the mal- 
ady, infiltrates ihe eyes and the skin. The mind chars, and the 
patient flatters himself that the attack is over. The shorter the 
time before this remission, the more dangerous the disease, the slower 
it comes on, the more hopeful the case. This calm is frequently 
deceptive. If it lasts m re than a day the disease may assume a 
typhoid character and last three or four weeks and the sufferer live. 



256 



MEDICAL PRACTICE. 



Usually after twenty-four hours the fever reappears with increased 
violence. The vomiting, more frequent at first and with greater 
force, brings to light quantities of aliered blood. This is the "black 
vomit." It is similar in nature to the dejections in cholera. Diarrhoea 
may occur. The prostration of the muscular and nervous systems 
is extreme. Blood flows from ihe mouth, gums and nostrils, and 
sometimes from the bowels. The stomach is scon disorganized and 
the vomiting ceases; delirium, collapse, hiccoughs and death ensue. 

It is distinguished from typhoid fever by its sudden appearance, the 
pre-ence of the epidemic, and by iis rapid changes from one stage 
to another; from the typhus fever by the brain symptoms, eruption 
and absence of hemorrhage, all occurring in the other. In some 
respects it closely resembles remittent fever, many of the symptoms 
of which, however, are milder in character. 

The indications are to relieve the stomach of bilious matter, equal- 
ize the circulation, overcome the congestion, vomiting and hemor- 
rhage, and excite the action of the liver. 

TREATMENT. 

Prophylactic means are of great advantage ; deserting the city 
for the pine woods and th? cooler climate, the use of the Turk- 
ish bath, and the use of some remedy that will keep up the 
activity of the liver and the abdominal viscera. Composition tea is 
valuable, or what is considered preferable, a pill composed of Lep- 
tandrin, Capsicum and Quinine. 

The treatment to speedily meet all the requirements above stated, 
should begin with a mild emetic of tincture lobelia. This throws off 
all biliary matter in the stomach and duodenum and rouses the liver 
and spleen to activity, opens the pores and frees the capillaries. 
Friction is necessary and may be accompanied with bathing with 
cayenne tea. Combining Leptandrin and Quinia in pill form and 
administering at the commencement of the remission, we free the 
liver of congestion and oppose the malarial poison. At the same 
time that we endeavor to overcome the vomiting we may use such a 
remedy as will nullify the tendency to putrefaction. An excellent 



MEASLES. 257 

recipe is one or two drops of carbolic acid mixed with one teaspoon- 
ful of glycerine. Mustard plasters may be applied over the region 
of the stomach. In many cases the cayenne tea alone has stopped 
the black vomit. For the hemorrhage give tannin or gallic acid. 

Measles. — Rubeola. 

Measles may be defined as an eruptive fever. It attacks all ages, 
principally the young. It is highly contagious and, as far as possi- 
ble, children should be carefully kept away from the invalid. The 
time between exposure and the fever is from seven to fourteen days. 
For a few days prior to the beginning of fever there is noticeable a 
feeling of languor, uneasiness, oppression, and want of appetite. The 
most noticeable symptom, however, is that of a cold and the dis- 
charge from the nose, as in acute catarrh and occasionally watery 
congestion of the eyes. On the fourth day an eruption appears upon 
the face. This extends over the whole body, passing downward to 
the feet. It lasts about five days, when it begins to disappear in the 
same order. There are little red spots, which soon run together and 
form crescent shaped patches with clear skin between. They do not 
fill with fluid as in small-pox. When it fades it leaves a yellowish 
discoloration, and very fine scales are thrown off. The catarrh is 
characteristic. There is a discharge accompanied with sneezing, and 
which may linger after the disease has passed away, developing 
bronchitis or consumption. The skin is hot, and the temperature 
preceding the eruption may reach one hundred and four or five. 
After its appearance it steadily declines. 

It is distinguished from scarlet fever and small-pox by the peculiar 
eruption, its first appear.) nee on the face, its running into crescentic 
patches, and the constant catarrh. 

TREATMENT. 

There is but a single indication and this a most important 
one, namely: to bring out the eruption. My readers must be 
cautioned against the use of cathartics, which not only irritate 



258 MEDICAL PRACTICE. 

the mucous membrane already suffering in a similar manner 
as the skin, but in less degree, but principally because it may 
cause the disease to centre upon the mucous membrane and the 
bowels. Once located here it may prove fatal ; otherwise there is 
little danger. A light physic of calcined magnesia in milk, or of the 
following may be giveu at the outset; if it is deemed imperative. 

IJ. — Fluid Extract of Rhubarb, . one dram, 
Brandy, .... two drams, 

Essence of Spearmint, . thirty drops, 

Bicarbonate of Soda, . one dram, 

Simple Syrup, . . . four ounces. 

Mix. 

The use of teas of the sage and catnip by our grandmothers is 
founded upon fact and science. We prefer 

I£. — Asclepias (phuiisy root), . one part, 

Lobelia Leaves, . . one part, 

Cayenne Pepper, . . a small quantity. 

Mix. 

Make a tea by steeping a tablespoonful in half a pint of water 
sweetened. Give a teaspoonful every hour or two. Composition tea 
is an excelh nt remedy. The surface of the body may be bathed, 
under the coverings, with tepid water, in which is mixed soda and 
alcohol. 

We observe frequently at the termination of measles an active 
diarrhoea. This however lasts but a short time, and should be allowed 
to continue without interference; inasmuch as it is an effort of na- 
ture to riil the body of the blood-poison. 

Accidents may happen and it is best to be prepared for them. In 
a single hour, from sudden cold or from irritation of the stomach 
and bowels from improper food, the rash may entirely disappear. 
This suppression will greatly increase the fever and in fact all the 
symptoms, and disturb the brain, producing delirium or coma. 
Safety is only assured by re-developing the eruption. The infusion, 
increasing the amount of cayenne, should be given hot and repeated 



SCARLET FEVER. 259 

often. An alcoholic sweat should be administered and, if thought 
advisable, in addition, the whole surface of the abdomen may be 
treated to a hot pack with cayenne and water. 

In rare cases there is an absence of the eruption upon the surface. 
It will however be discovered upon the fauces. The treatment should 
be the same in every particular as though it had appeared. 

Black or Putrid Measles 

Differs from the other only in its intensity and the darker color of 
the eruption. There is more prostration of the strength of the sys- 
tem, more headache and more active fever. This depression of the 
nervous system is because of deficient power or vitality to throw off 
the disease and bring about reaction. The stomach and bowels be- 
come congested, and there is liability to a passive hemorrhage from 
their lining membranes. Black measles will sometimes pass into 
typhoid fever. 

Scarlet Fever. 

This disease is also called scarlatina, and in some parts of the coun- 
try, canker-rash. It is an eruptive fever, infectious, contagious and 
sometimes epidemic. It is remarkable for its easy propagation, and 
especial precautions are necessary to limit its ravages. Infection is 
contained in all discharges from the body during the progress of the 
disease and recovery, and more especially from the skin during con- 
valescence, when the dry scales are being shed. These latter are 
disseminated through the air and become attached to articles of furni- 
ture, bedding and clothing; and being inhaled, the disease maybe 
readily conveyed to another, and by those w 7 ho are not themselves 
suffering from it. 

While m< asles may attack a second and even a third time, persons 
have rarely been known to have a second attack of scarlet fever. 
The young are principally affected, and seldom does a case occur 
after the age of twenty or under that of two years. 

The disease is considered as being more mild, the older the patient. 



MEDICAL PRACTICE. 



The largest number and most malignant cases occur between the 
second and seventh year, and a much smaller number after the 
eighth year. Scarlatina prevails at all seasons, but a close air and 
foggy atmosphere seem favorable to its dissemination. The period 
between exposure and the appearance of the fever varies from a sin- 
gle day to several weeks. The disease in any form is the dread both 
of the physician and family or friends. An attack, slight at the 
commencement, may terminate speedily and violently in dissolution. 
On the contrary, a violent beginning may develop milder symptoms 
during its progress, and recovery be complete. This di-ease is fol- 
lowed by more organic diseases than measles. Recovery is much 
slower and attended with greater hazard, because a relapse from 
sudden cold or other cause, may produce death even after the pa- 
tient is supposed to be entirely free from any symptoms or traces of 
the disease. 

It is divide d into three varieties. Scarlatina simplex is the mildest 
form, and is ushered in with a chill, followed by rapid pulse, hot 
skin, loss of appetite, soreness of throat and difficult swallowing. 
The eruption appears in about twenty-four hours, first upon the 
neck and chest; but in a short time the rash is equally diffused over 
the whole skin — scarlet in color, presenting an appearance like that 
of a boiled lobster. Some parts are deeper-colored than others, as 
the neck, outer surface of the extremities and hands. The rash con- 
sists of an infinite number of small red points situated upon a rose- 
colored base, with here and there a vesicle or small pimple contain- 
ing a colorless fluid. The whole surface burns and itches. The 
throat is sore and swollen, but imflammation does not reach to that 
extent noticed in the second variety of this disease. On the fifth or 
sixth day after the appearance of the eruption, it commences to fade, 
with considerable abatement of the fever. The appetite speedily 
returns and the patient soon feels well. 

Scarlatina Anginosa. The symptoms in this form of the di-case 
an- more violent than in the preceding. Vomiting and even convul- 
sions may occur at the outset, The tongue, instead of being covered 
with raised red points, has a grayish coat, with intersperse 1 red 



SCARLET FEVER 261 

patches. In the throat seems to centre all the violence of the effects 
of the blood-poison. The neck appears stiff on the second day ; 
hoarseness and pain in swallowing ; fauces, tonsils and uvula red, 
swollen and covered with false membrane. Suppurating ulcers are 
noticed in the throat. The throat and tongue are parched, the thirst 
great and the breath offensive. With tue fading of the eruption, 
by the fifth or sixth day, the fever and inflammation of the throat 
commence to abate, although the throat may remain sore for some 
time after the disappearance of the rash. 

Scarlatina Maligna differs only in the symptoms being more aggra- 
vated. The fever soon assumes a malignant or typhoid condition, 
with restlessness and delirium of a low muttering character. The 
tongue is dry, brown, tender and chapped ; the lips, teeth and gums 
covered with sores. The mucous and salivary glands in the mouth 
and throat are much enlarged and inflamed, causing constriction 
and obstruction to the passage of food and sometimes of air. The 
eruption is irregular in appearance, dusky, or of a dark livid reddish 
hue. There is great, prostration of strength and the tendency to, if 
not the developement of, coma and other brain complaints. 

In addition to the erupdon and sore throat, other characteristics of 
scarlatina are the very rapid pulse and the exceedingly high tem- 
perature. The pulsations will-often count as high as a hundred and 
forty or more a minute. The temperature ranges higher than in any 

_Q. J! EM ANN & CO'S. PATENT JUNE /?. I87T 



Clinical Thermometer, (Self-Registering.) 
of the eruptive fevers, often reaching one hundred and ten or one 
hundred and twelve decrees, and continuing at this height in most 
cases until the eruption disappears. 

It is distinguished from measles and small-pox by its having an 
eruption peculiar to itself, which spreads rapidly, by the reddened 
and raised points upon the tongue, by the frequent pulse, high tem- 
perature and by the sore throat. In meaties there is the constant 



262 MEDICAL PRACTICE. 

catarrh and inflammation of the eyes (con j unci va). In small-pox 
there is a great pain in the back, the eruption first appears upon the 
forehead, which soon developes pustules. 

TJie indications are to bring out the eruption, to moderate the 
fever, to neutralize and eliminate the blood poison, to relieve the 
throat and sustain the strength. 

TREATMENT. 

One of the best means that can be adopted to bring out the 
eruption, is the alcoholic vapor bath. If the attack seems to be 
a severe one, or if the rash is tardy in its appearance, an emetic 
■will mitigate its violence and cause increased tendency to the surface. 
We know no better agent than tincture lobelia one ounce, and simple 
syrup two ounces; given in teaspoonful do.-es every fifteen minutes 
until the stomach responds. In ordinary cases the use of the cayenne 
and hot water pack to the abdomen, will be sufficient. A mild and 
simple, but effective remedy, is found in half-teaspoonful doses of 
camphor water administered every hour. The continued use of the 
alcohol bath or the hot rubber bag to the sides or between the knees, 
will moderate the fever as far as is advisable, taking strength and 
safety into consideration. Veratrum and Belladonna are the 
remedies for this fever. To neutralize the poison give five to twenty 
drops of tincture muriate of iron and simple syrup every four hours. 
If the person be old enough, this may be drawn from the tumbler 
into the mouth through a glass tube, having the upper end placed 
well back upon the tongue. If the patient refuses the iron, give in- 
stead the black cohosh tea sweetened. Two hours after a dose of 
one or the other of the above, the colchicum mixture (see page 244), 
should be dispensed. This does good service in eliminating the urea 
from the system, obviates the further depuration of the blood by this 
substance, and prevents its overpowering the brain. It will be found 
in large quantities in the urine. It occasionally happens that the 
bedding is found to be wet with urine, and the mother or nurse 
implies that the bladder has been evacuated. A mistake may be 
made here, and the real condition can only be discovered by apply- 



TYPHOID FEVER. 263 

ing pressure upon the bladder just over the pubic bone. It may be 
greatly distended, and the urine that has escaped be simply an over- 
flow. If, by manipulation, it is discovered to be large and firm, a 
hot pack upon which has been sprinkled spirits of camphor, should 
be applied over the organ and renewed as often as necessary until the 
confined fluid wholly or partially escapes. 

To relieve the severe inflammatory condition of the throat fasten 
around the neck a single thickness of flannel about two inches wide. 
Take four thicknesses of flannel, about three inches square when 
folded, saturate with the following liniment, and slip underneath the 
bandage so as to irritate the surface of the neck under the angles of 
the jaw : 

1$. — Sassafras oil, . . one ounce, 

Olive oil, , . . one ounce, 

Spirits hartshorn, . . one ounce. 

Spirits camphor, . one-half ounce. 

Mix. 

The external irritation detracts from the internal inflammation. 
Even if ulceration should follow, it might better be upon the surface 
and in sight. This treatment is also the bust safeguard against deaf- 
ness which so often follows, that we possess. If the throat is can- 
kered or ulcerated, u?e a spray of carbolic acid two grains to an 
ounce of water, made by the Atomizer. The strength may be sus- 
tained by using milk porridge or other light and unirritating fluids as 
food. Water, in small quantities, may be given to quench thirst, 
and repeated at short intervals if thought advisable. 

Disinfection of Scarlet Fever. 

" Scarlet fever is very infectious. A very mild case may give rise 
by infection to a very severe one. Infection is contained in all dis- 
charges from the body during the progress of the disease and re- 
covery ; but more especially from the skin during convalescence 
and when the cuticle is being shed. The dry particles which are 
separated from the skin are highly infectious, and r tain their in- 



264 MEDICAL PRACTICE. 

fectious nature for an unknown time, unless thoroughly disinfected. 
They are disseminated through the air, and become attached to arti- 
cles of furniture, clothing, draperies, wall-papers, etc. Thus the 
disease may readily be conveyed from one person to another by 
those who are not themselves suffering from it. It is also eonvej'ed, 
as has been mentioned, by bedding, clothing, and other articles, and 
by rooms which, having been exposed to infection, have not had 
their floors, ceilings, or walls disinfected, or had the wall-papers re- 
moved. 

No child should be permitted to go to school from an infected 
house, and communication of such in play or otherwise with healthy 
children should be prevented. 

When a person has had the disease, he should not be permitted to 
mix with others until he has perfectly recovered and has had his 
clothes thoroughly disinfected; and not even then without the per- 
mission of his medical attendant. Nor is it advisable that any one 
who has had the slightest communication with a person suffering 
from the disease should go to any church, meeting, public-house, 
fair, market, etc. Neglect of these precautions is a prolific cause of 
the spread of this disease. 

Attendants on persons suffering from Scarlet Fever should be 
chosen, if possible, from those who have already had the disease. 

It is believed that the dispersion of contagious dust from the pa- 
tient's skin is impeded by keeping his entire body (including limbs, 
head and face) constantly anointed with oil or other grease; and some 
practitioners also believe this treatment to be of advantage to the pa- 
tient himself. When the patient's convalescence is complete, the 
final disinfection of his surface should be effected by warm-baths, 
with abundant soap, taken on three or four successive days (under 
the direction of the medical attendant), till no trace of roughness of 
the skin remains. Aft* r this process, and with clean clothes, he may be 
deemed again safe for association ; but previously to this, however 
slight may have been the attack, he ought always to be regarded as 
dangerous to persons susceptible of Scarlet Fever. " 



ERUPTIVE FEVERS. 265 

Small,-pox — Variola. 

Small -pox is an eruptive contagious fever, attacking all ages and 
spreading rapidly in districts and localities where the population is 
overcrowded. Being so easily carried from one to another, every- 
means of disinfection within our knowledge should be resorted to, to 
confine it within limits. The time between exposure and the appear- 
ance of the fever varies from one to three weeks. The same feelings 
of depression and languor precede it as noticed in other eruptive 
fevers. With the beginning of fever there is nausea, vomiting, 
thickly -coated tongue, foul breath, rapid pulse, headache more or 
less severe, and great pain in the back. This latter symptom is 
characteristic. About the third day, an eruption appears of fine- 
pointed pimples with a hard top. upon the lips and forehead. They 
have not that intense red color witnessed in scarlet fever, nor the 
purplish red in measles, but have a medium tint. Soon after, they 
are noticed upon the chest, arms and body, and later, upon the limbs. 
A day or two after their appearance, some of them fill with water 
(serum), resembling little blisters; then the points. flatten and the 
contents become milky (containing pus), with red-inflamed base, and 
are painful. When these pustules are not distinct and separated 
from each other, but, as we say, run together, the disease is termed 
confluent small-pox, and is the more dangerous of the two. The pus 
formed in the eruption is absorbed to a greater or less extent by the 
blood, and as a result of this poisoning a secondary fever develops 
in all its strength, and all its ill effects, and continues until the scab- 
bing is well matured. On or about the tenth day crusts form over 
these pustules, which soon dry and fall off leaving a bright red spot. 
If the skin has been rubbed or scratched, or if the disease has been 
more than commonly violent, the " pits" or indelible marks of the 
disease are discovered. In persons of scrofulous constitution, blood 
may ooze from the mucous membrane. Hemorrhage of the bowels is 
not infrequent, nor is diarrhoea or dysentery a rare complication. 
The headache is sometimes so severe during the period of invasion 
as to resemble inflammation of the brain. During the progress of 
12 



266 MEDICAL PRACTICE. 

the fever the brain and spinal cord may be congested. Pustules 
sometimes form upon the eye, des:roying the sight. 

Suppression of the eruption is almost certain to prove fatal. 
Ulceration and suppuration of some internal organ rapidly follows, 
the nervous system is assailed at its centres, and the patient soon 
passes away. Occurring during pregnancy, it is very likely to prove 
fatal. 

It is distinguished from other eruptive fevers by the peculiar 
eruption first appearing upon the lips and forehead, by the head- 
ache, and more especially the severe pain in the back. There is the 
absence of catarrh, peculiar to measles. Sore throat may be present, 
as in scarlet fever, but the eruption will have developed enough to 
differentiate the two before the throat is to any considerable extent 
involved. Neither the pulse nor temperature rise as high in small- 
pox as in scarlet fever. A secondary fever belongs specially to this 
disease, but it is of little importance in this connection; for days be- 
fore this occurs, other manifestaiions have been presented which 
have confirmed the diagnosis. Erysipelas and this disease may be 
confounded in their earlier stages, but it will soon be noticed that 
one is limited to the face, while the other eruption shortly extends 
over the whole body. 

Varioloid 
Is small-pox in a milder form, modified by inoculation or vaccina- 
tion. That protection is afforded by vaccination is undeniable, but 
that it is as efficient, as is popularly believed, is an error. None will 
deny that small-pox itself makes a greater and deeper impression 
upon the sys'em, than vaccination ; and yet persons have been 
afflicted for a second and third time with this loathsome malady. 
Vaccination protects to a certain extent, and to this extent is it 
valuable and necessary. In this modified disease both pitting and 
the secondary fever are absent. In the fever at the beginning of an 
attack, the pulse and heat of the body are influenced but for a short 
period ; besides, the eruption is not so thick, the inflammation is 
diminished and the pustules ripen rapidly. 



VACCINATION. 267 

TREATMENT OF VARIOLOID 

Is the same as in genuine small-pox, but the remedies need not be 
administered so of len, and good nursing and protection from cold 
during convalescence, will complete the cure. Death seldom occurs. 
Its rarity is the principal argument in favor of vaccination. 

Vaccination. 

The best vaccine virus is obtained from the udder of a cow. Pus 
only should be secured, and may be preserved by allowing it to dry 
upon quill points. The scab from the arm of a child vaccinated by 
this may be eu ployed in operating upon others, providing that the 
health of the child and its family histoid are unquestionable. 

Vaccination often fails because the operation is imperfectly per- 
formed. If the following plan is adopted, better results are insured. 
The place most frequently selected, being the least troublesome, is a 
point but little above midway between the elbow and shoulder on 
the outer aspect of the arm, at the insertion of the deli oid muscle. 
If the operation is unsuccessful upon either arm at this point, and in 
cases of ladies objecting to a scar upon the arm, the inner surface of 
the thigh about half way between the knee and perineum, may be 
chosen. Make a dozen slight scratches with the point of a sharp 
knife or lance, close and parallel to each other. Care should be 
taken that the cuts are not ' so deep as to produce bleeding. 
Hemorrhage produces a flow outward from the wound, fills the 
openings and dilutes and absorbs the virus, or drying quickly, pre- 
vents its absorption into the system. A dozen other scratches 
should be made passing directly across the first, preserving the same 
distance between each. To insure success a third set may be made, 
making a sharp angle with either of the other two. If the quill is 
used, it may be moistened in water and rubbed upon the scarred 
spot. If a scab is to be employed, great care should be taken to use 
only one that has matured upon the arm, without having been 
scratched or rubbed off. A second scab is useless. Trim the edges 



268 MEDICAL PRACTICE. 

of the piece, scrape off the under and upper surfaces and preserve in 
dry raw cotton wrapped in rubber or tin foil. This preserves its 
virtues for a month or two. A small piece of this pulverized 
upon china or glass and moistened, may be applied to the 
arm with a quill in the same manner as the vaccine- 
point. On the fourth or fifth day inflammation appears 
which continues for a week when the vesicle has reached its 
height and begins to decline. In a few days it disappears entirely 
and the scab which was formed drops off, leaving a pitted scar. A I 
good vaccination is able to protect the individual for ten years and 
perhaps longer. It is performed usually during the first year of life 
and should be repeated after puberty. In some individuals vaccina- 
tion causes indisposition with some fever. Rest lor a day or two is 
all that is necessary, w hen the symptoms will disappear. 

We quote Ricord's words: "If ever the transmission of disease 
with vaccine lymph is clearly demonstrated, vaccination must be 
altogether discontinued; for in the pre>ent state of science we are in 
possession of no criterion which may permit the conscientious practi- 
tioner to assert that the lymph wit'i which he inoculates is perfectly 
free from admixture with tainted blood." And yet later he says: 
"At first I repelled the idea that syphilis could be transmitted by 
vaccination. The recurrence of facts appearing more and more con- 
firmatory. I accepted the possibility of this mode of transmission — I 
should say with reserve and even with repugnance — but to-day, 
I hesitate no more to proclaim its reality." 

Chicken Pox. — Varicella. 

Closely resembles small-pox in some particulars, but is even more 
gentle than the varioloid. There is little fever and the eruption 
appears in successive crops, confined mostly to the body. The ves- 
L-les become pointed, fill with fluid, then dry and form a scab 
which is soon rubbed off and leaves no pock-mark. Occasionally 
pustules are formed and in these instances marks may be left, but 
they are widely separated and few in number. Attention to diet, 



SMALL-POX. 269 

the alvine evacuations, protection from draughts of air and sudden 
changes of temperature are all the care necessary. 

TEEATMENT OF SMALL-POX. 

The indications in small-pox are to develop the eruption, neutral- 
ize the poison, reduce the fever, support the system, and prevent pit- 
ting of the face. 

The eruption can be well developed by the use of the alcohol vapor 
bath, but it is preferable for several reasons to use the lobelia emetic. 
The body may' be bathed under the bed coverings with hot water and 
alcohol. As in all eruptive diseases, harsh cathartics must positively 
be avoided. If in the early stages movement of the bowels is thought 
to be necessary, give a teaspoonful of calcined magnesia in milk. 
Lobelia seems to have a specific effect upon the blood poison and 
should be given in doses of from three to ten drops every four hours. 
Two hours after each dose administer the same quantity of tincture 
or infusion of pleurisy root (asclepias). When suppuration and sec- 
ondary fever begin, supporting treatment is indicated. A small 
quantity of milk to which is added a few drops of capsicum (cayenne) 
may be uiven every hour or two. Beef tea is valuable for its stimu- 
lating effect. Wine-whey or milk-punch, may be necessary. 

The worst marks upon the face are caused by rubbing or scratch- 
ing. The itching frequently seems unbearable, and the hands seek 
the face unconsciously or regardless of results. Pitting maj r be 
prevented by either of three processes : first — 

1^. — Glycerine, .... one ounce, 

Carbolic Acid, . . . twenty drops. 

Mix. 

With this saturate pieces of old linen and lay upon the face. The 
objection to this is that it requires changing every three or four 
hours, besides necessitating careful and accurate adjustment. 

Second. Add glycerine to collodion. With this paint the whole 
face, using a camels' hair brush. 



270 MEDICAL PRACTICE. 

Third. Dissolve india-rubber in chloroform and apply with a 
brush. 

Hectic Fever. 

The medical profession are in the habit of applying this term to a 
group of symptoms, which make their appearance during the latter 
stages of debilitating diseases. It is met most frequently in long 
continued fevers, in organic diseases particularly, in marasmus 
and lung consumption and in slow poisoning. There is great loss 
of flesh, palid surface, red, smooth and clean tongue, scanty and 
reddish urine, a redne^s of the cheeks during the afternoon called 
hcctk JfusJi, excessive perspiration during the night and sometimes 
diarrhoea. 

TREATMENT. 

This belongs properly to the disease which causes the hectic fever. 
We find this a convenient place however lo make a few remarks 
upon the subject of night sweats which are so exhausting. One 
remedy will be advised in considering the treatment of consump- 
tion. There are others little less valuable that may be more con- 
venient. The leaves of the sage is an old remedy. Take of sage 
leaves a handful, boiling water a half pint. Steep, cool, strain 
through cotton cloth and sweeten. Take in the evening. Most 
physicians rely upon acids, which seem specifically indicated by the 
red tongue. A pleasant form of administration is : 

3$. — Sulphate of Quinia, . . . sixteen grains, 
Compound spirits of Lavender, . . two ounces. 

Aromatic Sulphuric acid, , , . sixteen drops. 

Mix. 
Take a half teaspoonful in water every four hours. 

Another still more pleasant than the last, as effective generally, 
and requiring but little medicine, is : 

l\ — Fluid exiract of GeLeminum (green root), one dram, 
Essence of Wintergreen, .... twenty drops, 

Simple Syrup, four ounces. 

Mix. 
Take a teaspoonful every two, three or four hours. 



EPIDEMIC FEVERS. 271 

CHOLERA. 
Asiatic, Indian, Oriental, Spasmodic, Pestilential, &c. 

This is an epidemic and infects districts more or less extensive, 
sometimes sweeping over whole countries. The first approach of 
the disease is felt by uneasiness, headache, lassitude and diarrhoea. 
This latter may he painless and slight and attract little notice. This 
may lead to a fatal mistake, as many an one has lost his life in con- 
sequence. The patient next complains of nausea and inclina'ion to 
vomit. The pulse is quick but feeble. These symptoms last but a 
short time, when the drea led prostration or collapse follows. The 
discharges from the bowels are colorless, inodorous, frequent, and 
resemble rice-water or whey, and signify destruction of the mucous 
membrane and decomposition of the blood. The vomiting becomes 
more severe, and has the same rice or water-gruel character. Cramps 
of the toes and fingers appear, soon involving the hands, arms and 
legs. Thirst is intense. Although complaining of heat, the skin and 
tongue are cold, the cramps severe, the skin and lips blue, eyes 
sunken, urine suppressed, and pulse almost imperceptible. The dis- 
charges are thin and continue, while the patient rapidly sinks. 

It is distinguish d from cholera morbus by the more sudden and 
greater prostration, by the rice-water discharges, and by the preva- 
lence of the epidemic. Both disorders are attended with cramps, 
vomiting and purging. 

TJve indications are to check the diarrhoea, promote perspiration, 
and establish reaction. 

TREATMENT. 

At the outset it is easily arrested. There is no better remedy than 
the neutralizing mixture made of — 

1$. — Fluid Ext. of Rhubarb, . . one dram, 



Brandy, 

Ess. Peppermint, 
Bicarbonate of Soda, 
Simple Syrup, 



two drams, 
thirty drops, 
one dram, 

four ounces. 

Mix. 



272 MEDICAL PRACTICE. 

Dose, a tablespoonful every half hour or hour, according to cir- 
cumstances. 

To the above may be added with advantage one ounce of tincture 
of capsicum, or one ounce of spirits of camphor, or an ounce of the 
tincture of xanthoxylum. 

If there is much pain and the diarrhoea is active, give — 
I£. — Tincture of Opium, . . one ounce, 

Tincture of Camphor, . . one ounce, 

Tincture of Capsicum, . . one ounce, 

Chloroform, . . . three drams, 

Alcohol, sufficient quantity to make . five fluid ounces. 

-Mix. 

Dose, twenty to sixty drops. Rest in the horizontal position is 
imperative. A diarrhoea in hot weather should be the signal for a 
day's rest. The excessive thirst noticed in some must be only par- 
tially gratified. Bits of ice answer the purpose. Much fluid aggra- 
vates all the bad symptoms. 

If the cramps are excessive and frequent take — 

1$. — Comp. Spirits Lavender, . . one ounce, 

Chloroform, .... one dram, 

Fluid Ext. Gelseminum, . . two drams. 

Mix. 

Give a teaspoonful every half hour in alternation with the above. 
If collapse is threatening or has actually occurred, no time must be 
lost or any means left unemployed that will produce perspiration. 
Internal stimulants, like cayenne pepper or composition tea, are 
likely to fail without external heat assists. The spirit-bath is now 
the anchor of hope. Equal parts of warm water and alcohol should 
be poured upon flannel that has been wrapped about bottles of hot 
water, securely corked, or about hot bricks or stones. Place four or 
five close to the body, but not near enough to t uch, and cover well 
with bed-clothes. When perspiration is fully restored ami kept up 
for some time, the patient is safe. Then water, a teaspoonful at a 
time, may be given, gradually increasing the quantity ; chicken- 



MIASMATIC! 273 

broth, milk and beef tea are in order. Bear in mind, however, the 
probabilities of relapse, and that it is precipitated usually by dietetic 
and other irregularities. 

A List of Diseases classified as Miasmatic, but considered under 
other headings. 

Influenza, see Class III, Local Diseases, Order IV, Diseases of 
the Nose. 

Diphtheria, Quinsy and Mumps, see Class III, Local Diseases, 
Order V, Diseases of the Mouth, Fauces and (Esophagus. 

Croup and Whooping-Cough, see Class III, Local Diseases, Order 

VII, Lung Diseases. 

DiARRHoeA and Dysentery, see Class III, Local Diseases, Order 

VIII, Bowel Diseases. 

Child-bed Fever, see Class IV, Gennetic Diseases, Order II, Of 
Women. 

Erysipelas, Cerbuncle and Boil see Class V, Order II, Diseases 
of the Skin. 

Gangrene, see Wounds. 
12* 



274 MEDICAL PRACTICE. 



ORDER II. ESTHETIC (Inoculated) DISEASES. 

Hydrophobia, Canine Madness,— Babies. 

This disease is rare, and although many cases occur to which the 
name is given, it has been proven beyond doubt that my statement 
is correct. Most of the sufferers from the feigned disease may have 
been bitten by a sick dog and the effect upon the mind is such that 
the difficulty in swallowing may supervene and eventually terminate 
in death. The progress in this direction has been stopped at times 
by the exhibition of the dog when excitement and worry were the 
causes, and these have been removed. When superstition induced 
the attack an announcement of the death of the animal has brought 
about recovery. The fear of hydrophobia is a disease only developed 
in the intelligent; the true ailment, uninfluenced by the mental fac- 
ulties occurring mostly in young children. It is a popular fallacy to 
believe that hydrophobia occurs most frequently during theexces-ive 
heat of summer. The careful collation of two thousand cases shows 
that they are about equally divided among the four seasons; that as 
many cases occurred in Winter and Spring as in Summer and Autumn. 
Another prevalent opinion equally erroneous is that a'l bitten are 
inoculated. Clothing, as a usual thing, protects the body, and may 
be described as wiping the tooth before its insertion in the flesh. 
Again, the tooth may have received such a cleansing in the person 
or animal previously bitten. Still another popular error is to make 
every effort to kill the animal. By so doing the parties receiving the 
wounds, their friends, and the physician himself, are left in the 
greatest uncertainty Loth in regard to the presence of this disease and 



HYDROPHOBIA. 275 

the possibility of its being another easily recognized and having no 
connection with the dreaded malady. A physician in Indiana believes 
the cause to be unsatisfied sexual desire, overheated blood from run- 
ning, and want of food during the time, all tending to vitiate the 
saliva, and when a struggle occurs among the dogs for possession of 
the female, the one bitten sufficiently deep becomes rabid. 

TREATMENT. 

There is nothing known to man so powerful to relieve the spasms 
as the spirit vapor or Turkish bath, and there is no relaxant so pow- 
erful and so free from harm in its effects and results as lobelia inflata. 
The drug may be administered in tincture, syrup or decoction. 

Dr. John Cameron'of Delaware mentions three little girls, aged re- 
spectively four, six and nine years, being bitten by a rabid dog. All 
the animals bitten by the same dog (and there were a number of them), 
died of this disease within five weeks after they were bitten. The 
wounds were cauterized, but not until the day after the wounds were 
received. 

No means have yet been found to equal in curative effects those of 
the Turkish bath. It is now some fifteen years since Dr. Buisson, a 
French physician, was cured by the vapor-bath, and yet it does not 
receive the approbation by the profession to which it is entitled. 
Drugs, frequently the most powerful and poisonous have been ad- 
ministered, very little thought being given to the probable effects of 
such upon a person of sound body and in good health. It reminds 
us of the heroic use of opiates with persons who have received severe 
injuries. Being unaccustomed to such excessive stimulation, doubts 
often arise, and with good reason, as to the cause of loss of life. 

Animals are much more likely to become maddened in cities, and 
these fortunately are, at the time of this writing, well supplied with 
Turkish baths. A healthy public opinion should be aroused upon 
this subject, and an imperative demand made that the sufferer shall 
receive this treatment first of all; one which is least harmful, and 
we believe most encouraging and effective. 

In the above instance, the baths were given daily for two weeks, 



278 MEDICAL PRACTICE. 

commencing on the sixth day after the wound. The delay was 
caused by the vain efforts of the physicians to interest others in their 
behalf and the treatment finally adopted. All the children are now 
alive and well. 

Dr. Cook of New York narrates a case of a child two years and a 
half old who was bitten by a spitz dog. Although this case termi- 
nated fatally, the beneficial influence of the Turkish bath was em- 
phatically proven. The treatment did not begin until several weeks 
had elapsed, and the doctor believes the real cause of death to be a 
want of food for thirty-six hours previous to the bath. 

Bites of Poisonous Snakes, Spiders, &c. 

The bite of a snake differs from that of a rabid dog in one import- 
ant particular. The tooth of the dog may be wiped by the clothing 
and thus freed of the poison before entering the flesh. The fang of 
the snake is hollow and the poison is injected into the flesh through 
this canal, and although the wound is not deep, the surrounding flesh 
must be instantly cut away or this means of relief is unavailable. 
The swelling should be treated the same as erysipelas and gangrene 
or ulcers, by compresses wet in a solution of sulphate of zinc or car- 
bolic acid. The poison renders the blood pasty and stops its circu- 
lation. It is for its interference with this process that alcohol or whisky 
are valuable. Besides it keeps up the circulation, prevents exhaus- 
tion, and abates in a great measure the shock to the nervous sys- 
tem. The water of ammonia taken internally has a similar effect 
and is preferable if it can be injected into the flesh or into a vein by 
the hypodermic syringe. Neither of these are true antidotes to the 
poison — do not neutralize it — but are valuable in resisting its pros- 
trating effects. " Bibron's antidote" very often signally fails, to 
say nothing of the difficu'ty attending its preparation and preserva- 
tion. We might expect from India, where snakebite is so common, 
a valuable antidote, but the natives " have little faith in the practice of 
educated physicians and unbounded confidence in the 'charm' 
treatment of the native medicine men," and thousands perish annu- 



SERPENT BITES. 279 

ally. It is reported that those who are bitten by a certain 
snake are tied to a vehicle and made to run, accompanied by the 
awakening admonitions of a sharp whip. The object, evidently, is 
execessive perspiration. From another source we learn that a man 
bitten by a rattlesnake, being at a distance from home, ran thither 
to die. This caused profuse perspiration and cured him. These re- 
ports require corroboration, but they suggest the use of the skin as 
an outlet for the venom. It is more sensible to have a current in 
every part tending towards the surface than one flowing iiiwr.rd 
toward the vitals. Probably the best antidotes lie in the plants of 
the Eupkorbian variety ami principally in the Euphorbia Prostata. 
Dr. Irwin, U. S. A., reported his investigations and experiments i a 
1861 and found it a specific in every case. "Knowing how abundant 
the several varieties of crotalus (rattlesnake) are in this region of 
country and never having heard of a case of death from the poison 
of this reptile, I inquired amongst the natives, Mexicans and civilized 
Indians and learned that although such injuries were very common they 
had an efficacious antidote in what they designate as ' Gallindrinia.' 
The Euphorbia Prostata grows plentifully in dry, hard, sandy places, 
especially in roadways, farm-yards, pathways and in a hard, compact 
and gravelly soil and has a frail, delicate appearance resembling in 
its external character the gold thread (cbptis trifolia) with long filli- 
form, reddish stems that spread and interlace with each other. Leaves 
petaloid, obcordate, regular, opposite, of a deep green color and 
varying in length from three to five lines (about an half inch). 
Flowers axillary and very small, white with dark purple throat. 
8 pals four, petals four. Pentandria Monogynia. Root quite large, 
dark brown color and possessing an abundance of milky juice, which 
pervades all pnrts of the plant ; taste insipid ; odorless. Flowers 
from April till November." To test it "experiments were made on 
many dogs and extended through a period of many months, with like 
s tisfactory results. The fresh milk-li^e juice of the stem, root and 
leaves was extracted by- pounding in a mortar and diluting with 
water In the southwestern portion of the United States and 



280 MEDICAL PRACTICE. 

in Mexico it grows plentifully through the whole year ; its prepara- 
tion is simple and its administration is unattended with danger to the 
animal economy. The M xican population of Arizona and Sonora, 
who are frequently subjected to the poisonous wounds from the rat- 
tlesnake, coral snake, vinegiilla, scorpion, centipede, tarantula and a 
host of other hideous creatures, are never injured fatally, as they 
resort to this specific which never fails to produce a sure and speedy 
cure." 

In more northern latitudes the chief antidotes are known as 
Devil's bit, Gay feather and Butt -nsnake root, of which the roots 
are the only parts used, and the following plants : spurge, miik-weed, 
milk-purslcy, wild ipecac, lion's foot or white lettuce and Rattle- 
snake violet. All these are used in the same manne-. The root or 
whole plant is bruised and a decoction with milk or warm water 
made and drank. At the same time a poultice of the same is applied 
to the wound. 

A simple remedy that can be had at any drug store or can be 
carried in the pocket in dangerous districts is Iodine tincture. Add 
twenty-five drops to a tumblerful of whisky and give a tablespo n- 
ful every hour. It is reported that "where the patient was swollen 
terribly, mottled spots appearing over the entire body, breathing 
with great difficulty and apparently near death, four drops of Iodine 
were given every hour with entie recovery." 

In stings from bees, icasj)s, Iwrneis, etc. , the poison is urous acid, 
and may be neutralized by applying a paste of calcined magnesia 
and water or prepared chalk and water, or ammonia water. If the 
sting is in the wound pick out with a needle or forceps. 

The bites of fleas, mosquitoes, and bedbugs may be treated in the 
same way. It is a difficult matter to poison fleas as they occupy so 
much territory. They may be driven away by sprinkling the 
clothes and bed coverings with essence of peppermint, spirits of 
camphor or solution of carbolic acid. Bedbugs may be poisoned by 
brushing with a feather or camels' hair brush all cracks or cavities 
about the wood work of a bed room and its furniture with corrosive 



IVY POISONING. 291 

sublimate, two drams, water and alcohol each one-half pint. Repeat 
once a month. After each operai ion throw away the remainder and 
break the bottle. Complicated furniture should be taken to pieces, 
and the binding in upholstered work removed and all folds opened 
and touched with the feather before replacing. Special attention 
should be given to the part farthest removed from the window or 
entrance of light. One or two such thorough trials will last a sea- 
son. Still a weekly "hunt" will do no harm. Mosquitoes may be 
driven away by smoke of most any kind. This is only a temporary 
relief. By far the best protection is netting, in the windows and 
over the beds. 

Poisoning by Vines and Shrubs. 

There are but few species of vines common to this country which 
are poisonous, and they belong to what is technically known as the 
rhus class or order. They are known in different sections by differ- 
ent names, and are confounded with each other. They are more 
commonly called poison oak, poison ivy, poison ash, poison wood, 
poison sumach, swamp sumach, poison elder and poison dog-wood. 
The symptoms are pain, redness, eruption, swelling and severe itch- 
ing. The face and hands, and particularly between the fingers are 
first involved. This rash may appear in spots on different parts of 
the body, and is always accompanied with the most painful itching, 
sufficient sometimes to deprive the person of sleep. Its duration is 
from a few days to two or three weeks. Occasionally it will produce 
a feverish condition and so disturb the constitution as to require 
medical treatment. 

TREATMENT. 

Waslfng frequently with soft water, in which is dissolved saleratus 

or baking-soda, will allay the itching and pain and give relief for an 

hour or two. If more efficient means are needed, di solve — 

1$. — Sulphate of Iron, finely powdered, . one ounce, 

Water, . . one pint. 

Mix. 



282 MEDICAL PRACTICE. 

Bathe the parts affected, or, better, the whole body two or three 
times a day. Internally may be administered — 

B. — Tinct. Rhus Tox., .... ten drops, 

Water, two ounces. 

Mix. 
Take a teaspoonful every two or three hours. 



POISONS. 



POISONING AND ITS TREATMENT. 

{Poisons not Inoculated.) 

Dunglison defines a poison to be " any substance which when in- 
troduced into the animal economy, either by cutaneous absorption, 
respiration, or by the digestive canal, acts in a noxious manner on 
the vital properties or the texture of organs." Quantity is an impor- 
tant factor: the amount of harm done being in proportion to the 
amount operating. A substance may be a poison and yet be taken 
in such minute portions that it is no longer noxious but on the con- 
trary salutary. Many of our most important remedies are poisonous 
and it would be impossible to substitute the non-poisonous. Many of 
our foods contain these subtle agents, but the amount is almost inap- 
preciable or so combined chemically as to be far from injurious. 

In the trades and manufactories poisons are most frequently re- 
ceived through the skin or by the lungs, and the effects are slowly 
but constantly progressive. In the household they are accidentally 
swallowed. The careless and indiscriminate use of poisons for rats, 
mice, insects, etc., particularly among children, cannot be too se- 
verely censured. Caution has been preached to "older heads,'' who 
should know better about finding a bottle in the dark and swallow- 
ing part of its contents. Occasionally physicians pay the penalty of 
such recklessness. Have all bottles labelled. If not labelled, empty 
them and break the bottle. Bottles that have contained medicines 
or poisons should be broken first and then disposed of. / never use 
the same bottle a second time. Glassware is loo inexpensive to take the 



284 MEDICAL PRACTICE. 

least hazard. Smell and taste before swallowing. You might better 
burn your tongue than eat a hole through your stomach. Poisons 
should be placed in an odd-shaped botile. A three-cornered one has 
been manufactured for this purpose, but the objection is, it is difficult 
to find outside of large cities. A plan adopted in my family for 
years is to tie a red ribbon in a hard knot about the neck of the bottle, 
leaving ends to hang. In the da}' time this speaks for itself, and ne- 
cessitates reading the label. If it was handled in the dark the touch 
of the ribbon would suggest, in an unmistakable manner, the danger. 
In supplying outfits of family remedies I enclose the boitles contain- 
ing remedies to be used with care or in drop-doses in neat metallic 
cages, made specially for this purpose. 

The treatment in general consists of the use of substances, which, 
by chemical combination, neutralize, as acids with alkalies, and vice 
versa ; by solvents, which take up the poiscn, as olive oil with carbolic 
acid ; by emetics which dislodge it, as mustard and warm water, sul- 
phate of zinc and warm water, or tickling the throat with a brush, 
feather or the finger; by the stomach-pump if at hand; by stimulation, 
until the effects pass off, and by electricity and the treatment about to 
be given for apparent death or suspended animation. For emetics it 
will not do to use lobelia and other nauseants, as these relax the 
system and encourage absorption. Mucilages, such as the white of 
the egg or slippery elm tea, may be given to shield the coats of the 
stomach and intestines, and these followed with castor oil and mag- 
nesia, to carry it away from the system. We will notice some of the 
more common poisons, their symptoms and the particular treat- 
ment for each. 

ACIDS. Acetic acid, Citric acid, Tartaric acid. The symptoms 
are, sour taste, "burning of the throat and stomach, cramping, 
thirst and the matter vomited is streaked with blood. Give 
calcined magnesia, a teaspoonful to a pint of water, stir and 
give Irequent draughts. Vomit occasionally to relieve the stomacli 
of its gas and liquid contents and to supply fresh antidote. When 
the burning ceases give mucilages and cathartics. 



POISONS. 285 

Tiurie acid (oil of vitriol). Symptoms same as above but inten- 
sified. The matter vomited has the appearance of coffee grounds 
and is streaked with mucus and blood. Give as little water as possi- 
ble, for in combination with this acid it produces great heat. Cal- 
cined magnesia and water or s >ap and water in the form of paste or 
soft soap is the remedy. Follow with emetics and when burning 
ceases, white of eggs, glycerine or slippery elm tea. 

Muriatic acid (spirits of salt) JS Uric acid (Aqua Fortis) Oxalic acid 
(salts of sorrel). These are powerful corrosive poisons and must be 
antidoted promptly. The latter is often taken by mistake for Ep- 
som salts. Oxalic acid is sour, not bitter like Epsom salts and is more 
transparent. Give the carbonates of lime and magnesia. The 
stomach pump should be use 1, but cannot always because the mem- 
branes and tissues of the throat are already destroyed and the 
instrument only adds to the injury. 

Pnissic Acid, Oil of Bitter Almonds, Laurel Water. In any 
appreciable dose this is immediately fatal. In smaller quantities its 
poisonous effects produce dizziness, headache, paralysis of arms and 
legs, and foaming at the mouth. Give stimulants, dash cold water 
on the head, rub and strike the body all over. 

Carbolic acid is also corrosive. Give olive or castor oil, any fats, or 
glycerine. Calcined magnesia is a good antidote. 

ALKALIES, Ammonia, Aqua Ammonia (spirits of Hartshorn), 
Muriate of Ammonia (sal ammoniac), lime, potash, nitrate of 
potash, (saltpetre) carbonate of potash (pearlash, lye). The symp- 
toms are severe burning in the throat and stomach, and sometimes 
vomiting of bloody matter. Give frequently a tablespoonful of 
vinegar or lemon juice. Follow with cathartic of castor oil. 

ALCOHOL. The symptoms of intoxication may continue for 
sometime before insensibility. In another part of this volume we 
have noted the difference between this condition and others (see 
Coma.) It also resembles the effects of poisoning by opium. In the 
former, however, the face is generally flushed and the pupils dilated ; 
in the latter the face is pale and the pupils contracted. An emetic 



286 MEDICAL PRACTICE. 

"will reveal the true state of affairs. Give an emetic of salt or mus- 
tard ; if the head is hot dash water upon it, keep up motion and 
rubbing and slapping to increase the circulation. 

ACONITE. This root has sometimes been swallowed for horse- 
radish. The symptoms of poisoning by this means or by an over- 
dose are tingling and numbness of the tongue, throat and limbs, 
difficulty of swallowing, severe pain in the stomach, vomiting and 
purging, pallid skin, labored breathing, impaired sight, dilated 
pupils, feeble pulse and great prostration. Give an emetic of sul- 
phate of zinc in water or of three or four spoonfuls of table salt and 
water. Use an alcoholic stimulant or mix ten or twenty drops of 
water of ammonia in a litt'e water and inject into the skin. To 
keep up the strength while the effects of the poison last, give 
tincture of nux vomica in five drop doses every hour. 

ANTIMONY. Tartar Emetic, Muriate (or butter) of Antimony, 
Oxide of Antimony. These salts have also been taken in mistake for 
Epsom salts. The symptoms are burning pain in the stomach, vio- 
lent vomiting and purging, cramps, spasms and collapse. Givean 
astringent infusion of oak bark or strong tea after unloading the 
stomach by tickling the throat or by copious draughts of warm water 
or flour of mustard and water. 

ARSENIC. White Arsenic, Yellow Sulphuret of Arsenic (King's 
Yellow), Bed Sulphuret (realger), Oxide (fly powder), Ratsbane, Fow- 
ler's solution, arsenical soap, arsenical paste, Scheie's Green, Paris 
Green. It is met most commonly in the various powders for the 
destruction of vermin and in the colors for paints and paper hang- 
ings, (see Arsenical Walls). The symptoms of poisoning come on in 
about an half hour after swallowing. That absorbed from pigments 
is very slow in its operation, but as soon as recognized should 
receive antidotal treatment. There is a nausea, violent burning pain 
in the stomach, vomiting and purging, intense thirst, great prostra- 
tion, convulsions and death. Give a powerful emetic at once. The 
sulphate of zinc and water is good. Milk may then be given and 
the emetic repeated. It may require three or four repetitions to 



POISONS. 287 

dislodge the sticky paste from the walls of the stomach. Next ad- 
minister the antidote. The hydrated peroxide of iron is usually pre- 
scribed, but it deteriorates by contact with the air. It is much better to 
make a fresh and perfect antidote when wanted. This may be used in 
almost any quantity without injury. It is simple and always accessible. 
1$. — Muriate tincture of iron, . . one dram, 
Bicarbonate of soda, . . .one dram, 
Warm water, . ... a teacupful. 

Mix. 

Thus the sesquioxide of iron is immediately formed in a solution 
of common salt. Oils or mucilaginous drinks should be given to 
protect the stomach. 

BELLADONNA. Deadly Nightshade. Children have been poisoned 
by eating the berries and by accidental overdose of the prepared 
drug. The symptoms are hot and dry throat, flushed face, dilated 
pupils, staggering gait, delirium and coma. Give an emetic of sul- 
phate of zinc and warm water and follow with brandy and laudanum. 

CANTHARIDE8. Spanish fly. Thisisignorantly given with crimi- 
nal intent. It produces burning in the throat, thirst, vomiting and 
purging, sharp pains in the bladder with desire but inability to pass 
water : if any escapes it pains and scalds. The prostration is great 
and sometimes fatal. Give emetics with warm water, follow with oil 
and stimulants, if necessary. 

CHLOROFORM and ETHER. In certain diseases of the heart a 
slight effect may produce death. When chloroform is carelessly given 
and its influence is increased until the voluntary muscular system is in- 
volved, the breathing becomes slower, the pulse fails, the countenance 
becomes livid and the heart ceases. The most frequent difficulty 
experienced by its use comes from vomiting and the lodgment of the 
food in the throat. The party is unable to remove this and needs 
assistance or suffocation ensues. 

TREATMENT. 

Much can be done in the way of anticipating trouble and preparing 
for it in advance. The patient should fast six or eight hours before 



288 MEDICAL PRACTICE. 

its administration. A half hour before give a drink of brand}', remove 
all constrictions about the neck and waist. The patient should be 
confident and not averse to the anaesthetic, and the physician or 
attendant cheerful ; the first inhalations but slight and well mixed 
with air ; the position as near horizontal as possible. Above all the 
chloroform or ether must be pure. With the first appearance of 
deficient or oppressed breathing apply spirits of ammonia (hartshorn) 
to the nostrils. If vomiting occurs, turn the head to one side and 
clear the throat with the finger. If danger still threatens and the 
face is pallid lower the head and shoulders, apply the ammonia, 
sprinkle the face with water or dash it upon the head and give vigor- 
ous blows with the palm of the hand upon the back or si les below 
the shoulder blades and prepare for and if necessary resort to, arti- 
ficial respiration as elsewhere described. This should be kept up for 
a long period even after all appearance of life has ceased. 

COPPER. Sulphate of Copper (Blue Vitriol), Subacetate of Copper 
(Verdigris). This poison will be found in acid foods or fruits cooked 
or kept in copper vessels. It is copper that gives the green color to 
pickles. The symptoms are coppery taste in the mouth, pain in the 
head and stomach, grilling, vomiting, purging and sometimes con- 
vulsions. Give emetic of warm water or mustard and warm w r ater. 
Do not give vinegar or acids. After emesis give milk or white of 
egg and oil. 

GELSEMINUM. The symptoms are those of complete relaxa- 
tion : inability to raise the foot, hand or eyelids, speech difficult 
and indistinct, countenance pale. Even these symptoms will gradu- 
ally wear aw r ay in from six to twelve hours and leave no bad effects. 
Place the subject upon the back and have him remain so. The dan- 
ger is in sitting up or standing up. The antidote is Nitrite of Amyl: 
a few drops upon a handkerchief and the vapor inhaled. This 
Hushes the face and may be employed at short intervals as long as 
the countenance continues to possess the deathly palor. 

HEMLOCK. Poison-Hemlock, Water-hemlock, Poison-parsley. 
The leaves of hemlock have been taken in mistake for parsley and the 



POISONS. 289 

root of the water-hemlock for parsnips. The symptoms are dryness 
of the throat, thirst, dizziness, nausea, numb feelings, paralysis and 
convulsions. Give emetic of sulphate of zinc and water or salt and 
water, stimulants. Keep up motion and rub the extremities. 

IODINE. Poisoning may result from swallowing a lotion con- 
taining this drug or from its use as a remedy on account of sensitive- 
ness to its influence. The latter is called Iodism. The symptoms 
of the former are cramps, vomiting, purging, thirst, trembling and 
fainting. In the latter the effects are more tardy, the symptoms are 
the same but less marked. There is fever, diarrhoea, nausea, palpi- 
tation and great loss of flesh. These gradually disappear upon dis- 
continuing the drug. The antidote is starch. Give in water and 
follow with emetic. Repeat if necessary. 

IVY. Poisoning by ivy and other vines is noticed in another part 
of this class. See Index. 

LEAD. Poisoning by lead also receives consideration elsewhere. 
See Index. 

MERCURY. Bichloride of Mercury (Corrosive sublimate), Calo- 
mel, white or red precipitate, vermillion, turbpeth mineral. Symp- 
toms, metallic taste, vomiting and purging of bloody matter, intense 
thirst, difficulty in speaking, breathing and urinating, convulsions, 
coma and death. Give promptly the white of eggs mixed in water 
or milk. Use the stomach pump or produce emesis by tickling the 
throat. Again fill the stomach with the egg and water or milk or 
even flour and water. The resulting inflammation may be treated 
as gastritis. 

MUSHROOMS. If you are not familiar with the difference be- 
tween the poisonous and non-poisonous mushroom, never gather 
those which grow in dark and damp places, or still better, dispense 
with them all ogether. The poison is tardy in its action. There is 
pain in the stomach and bowel*, vomiting, purging, stupor or deli- 
rium and convulsions. If vomiting has not occurred, give an emetic 
of flour of mustard and water, or table-salt and water, and follow 
with active cathartic. Apply hot packs to the abdomen to relieve pain. 
13 



290 MEDICAL PRACTICE. 

OPIUM, MORPHINE, LAUDANUM, PAREGORIC, God- 
frey's cordial, Soothing (?) syrup. In a half hour after taking this 
drug, drowsiness comes on followed by stupor. From this the pa- 
tient may be roused but at once relapses. The pulse is small and 
irregular, the surface warm and flushed, pupils contracted, at a later 
period, dilated. Give emetics of sulphate of zinc and water. Sometimes 
the sensibility of the nerves of the stomach are so deadened that 
emetics will not act. Persevere, however, and by rousing the patient l 
and irritating the throat you will be successful. These must be re- 
peated until the stomach is cleansed of its contents. Then give strong 
coffee or a solution of tannin. The pa'ient must be kept in continual 
motion. Take off the clothes and walk him in a warm room. If 
an adult, two stout men should perform this office. They must be 
relieved by others at the end of an hour, for in that length of time 
they will be completely exhausted, for the body has literally to be 
carried. At the same time he must be frequently aroused by smart 
blows with the palm of the hand or by flagellation or flapping the body 
with the corner of a wet towel. When all else fails, artificial respi- 
ration should be kept up for a considerable time. (See Index.) By 
these means the effects of the drug slowly wears off— the narcotism 
gradually disappears. 

POTASH. See Alkalies, above. 

POTASSIUM. The cyanide of potassium is used in the arts, partic- 
ularly by photographers. When swallowed it produces all the symp- 
toms of poisoning by 

PR USSIG A CID. See Acids, above. 

PHOSPHORUS. — Children become poisoned by eating: the ends 
of matches or phosphorus paste, used as a vermin and roach poison, 
and to kill rats. The symptoms are intense thirst, nausea, severe 
puin, and the odor of garlic in the breath and vomited matter. No 
antidote is known. Give calcined magnesia in milk, and afterwards 
emetics of mustard-flour and water. 

SNAKE BITES. See Index. 

STRYCHNINE. Nux Vomica, St. Ignatius' Bean, Rat Poison.— 



POISONS. 291 

The symptoms arc restlessness, twitching of the muscles, convulsions 
with strong contractions, spimj 1 ent backwards and head thrown 
hack and asphyxia. 

TREATMENT. 

With all possible dispatch give an emetic of twenty or thirty grains 
of sulphate of zinc (white vitriol). After this operates administer a 
strong solution of tannin or draughts of strong coffee. Control the 
convulsions by inhalations of chloroform, a teaspoonful poured upon 
a napkin and placed near the nostrils. Between the paroxysms give 
chloral dissolved in water. The patient should be allowed to go to 
sleep if so inclined; at all events kept perfectly quiet, for any shock 
to the surface brings on the convulsion. 

TOBACCO. — The symptoms are faintness, giddiness, vomiting, 
great prostration, delirium, and convulsions sometimes. Administer 
stimulants, such as brandy, by the mouth or rectum, strong coffee 
and the spirit vapor-bath. 

VERATRTJM YIRIDE. American Hellebore. — In poisonous doses 
it produces nausea, persistent vomiiing, copious perspiration, great 
prostration, coldness and pallid surface, slow and labored heart ac- 
tion, feeble pulse and stupor. In medicinal doses and combined 
with a stimulant like alcohol or the essential oils no unpleasant 
effects are produced. 

TREATMENT. 

It is useless to attempt to give any remedy by the mouth, for the 
stomach refuses everything, even a half teaspoonful of brandy. 
Stimulants are indicated, and when used should be thrown into the 
bowel. In three cases of poisoning, which came under my personal 
observation, I was supplied with stimulants, but did not use them. 
After the vomiting ceased, profound sleep for one or more hours 
followed. The persons awoke weak, it is true, but presenting no 
other untoward symptoms. In twenty-four hours all traces had dis- 
appeared. 

ZINC. Sulphate of Zinc (white vitriol), CJiloride of Zinc (Burnett's 
disinfectant). — Sulphate of zinc produces pain and violent vomiting 



292 MEDICAL PRACTICE. 

in large doses, but seldom death, as it is an emetic. Warm water 
may be freely given to assist emesis. The chloride is corrosive, and 
is accompanied with vomiting, pain and burning sensation in the 
throat and stomach. Give the white of eggs in water or milk. 
The inflammation following may be severe and perhaps fatal. 
If the Exact Poison is 
UNKNOWN, 
It will be best to follow a general plan of treatment. We want an 
emetic, antidote and cathartic. For the first, tickling the throat 
with a feather or finger will generally succeed. In all cases, except 
poisoning by sulphuric acid, warm water may be freely given. This 
will either cause vomiting of itself or facilitate emesis by irritating 
the fauces or throat. For an antidote that will meet the great major- 
ity of poisons, give a mixture of equal parts of 

E. — Calcined Magnesia, 

Pulverized Charcoal and 

Sesquioxide of Iron. 

Mix. 

The latter is made as described above, under the heading Arsenic. 

Castor oil is the best cathartic for general use in poisoning, and is 

found in all drug and country stores. 

A List of Diseases classified as Enthetic, but considered under 
other headings. 

Purulent Opewhalmia, see Class III, Local Diseases, Order II, 
Diseases of the Eye. 

GoNORitnceA and Syphilis, see Class IV, Gennetic Diseases, Order 
I, Of Men. 

Malignant Pustule, see Class V, Diseases of Bone, Muscle and 
Skin, Order II, Skin Diseases. 



SCURVY AND RICKETS. 293 



ORDER III. DIETIC DISEASES. 

Scurvy — Scorbutus. 

Scurvy is an impoverished and altered condition of the blood re- 
sulting from defective food. We find it among sailors, soldiers and 
others who are at sea for long periods or are kept upon salt meats, 
impure water, etc., who are supplied with vegetables in limited 
quantities or are without them entirely. Fifty j^ears ago it deci- 
mated the navies of England to an alarming extent. It is not so 
common now, chiefly from better hygienic regulations and the use 
of canned foods. The symptoms are black and blue or purplish 
spots upon the surface resembling bruises, loose teeth, spongy and 
bleeding gums, flabby tongue, pale face, fetid breath, dry skin and 
swollen joints. General debility is well marked and there is tendency 
to diarrhoea and dropsy. 

TREATMENT. 

This is simple and consists mainly in supplying deficiencies and in 
better hygienic regulations. The vegetable acids, such as vinegar 
and lemon-juice, are necessary, also green vegetables, fresh air, warmth 
in clothing and in climate, if possible, and cleanliness. 

Rickets — Rachitis. 

Children of scrofulous parents suffer from this disease, or it may 
result from innutritious food, impure air and the want of hygienic 
surroundings. The first child is rarely rickety. The bones soften, 
readily curve and are unable to support the weight of the body or 



294 MEDICAL PRACTICE, 

even the contract ion of the muscles, weak as they are. The head and 
upper part of the body sweats. The back is bent in the form of the 
letter S, the breast bone projects, the long bones are thin, but the 
ends are large, making the joints prominent. The head is narrow 
across the forehead, the "soft spot" does not close or harden and is 
depressed. The shoulder blades project upwards. Dentition is 
retarded ; the child may be two years of age and have but two teeth. 
These often rot and fall ont. The belly is uncommonly large and if 
the child stands upon its feet the bones of the legs become bent. 
This it seldom attempts to do and will remain where placed for hours. 
The bowels are irregular and the dejections fetid. 

TREATMENT. 

This consists principally in supplying proper nourishment and 
hygienic means such as air, sunlight and salt water batLis. The great 
need is the phosphate of lime which hardens the bones and builds up 
the teeth and some easily assimilated fat like cod-liver oil. No better 
preparation can be employed than that recommended in the treat- 
ment of consumption which combines these substances in a palatable 
form. If the mother is debilitated by over-suckling it would be 
better to substitute a healthy nurse or give cow's milk. If it passes 
from the bowels undigested add pepsin. In this way a remarkable 
change will be effected in one or two months. 

Goitre — Bronchocele. 

It is seldom that the throat-gland (thyroid) enlarges to such an 
extent as to interfere with respiration. If such a condition should 
arise it may then be wise to consider surgical means of relief, which 
involves its extirpation. So far the history of surgery presents but 
few instances of radical cure by this method. A plan of treatment 
that has been carried on for many years is to paint the neck with 
iodine, and administer internally the tincture of iron sometimes 
combined with iodine and sometimes not. A more successful 
method is the administration of an alterative syrup. The. Queen's 



OPIUM HABIT. . 299 

are so many and the trial is so protracted and exhausting, that very- 
few have the courage to persevere. 

The indiscriminate administration of opium and morphine for the 
relief of pain, places much of the blame for this habit upon phy- 
sicians' shoulders, 



300 MEDICAL PRACTICE. 



ORDER IV -PARASITIC DISEASES, 

Worms. — Vermes Intestird. 

There are in this country four kinds of worms that infest the 
alimentary canal. First : The ascaris lumbricoides or long round- 
worm, closely resembling the common earth worm in shape, tapering 
at both ends, from four to eighteen inches in length, and white or 
pinkish in color. It inhabits principally the small intestines but 
sometimes ascends to the stomach (some people call them stomach 
warms) from which it is ejected by vomiting. Sometimes it creeps 
out of the mouth or nostrils and occasionally travels to the rectum 
and passes away with the excrement. A large quantity of mucus 
seems necessary to its existence. In fact we are inclined to believe 
that worms in the body, like their relatives outside, subsist and 
flourish best in materials in a process of decay or putrefaction. 
Hence we look upon their presence as a sign of indigestion, fermen- 
tation or some other deficiency in the functions of the stomach or 
bowels. Once in possession they must be expelled, for no improve- 
ment in diet or general health will destroy them. 

Second : The Ascaris Vermicularis or pin-worm. It is from one- 
quarter to one half an inch in length and about the size of a 
small sewing-thread. It inhabits the rectum mainly, but is found 
anywhere in the intestines. It is met in great numbers, producing 
great irritation of the anus, particularly at night. 

Third : The TricocepTialus or long thread-worm. This is like the 
former variety, except being three or four inches in length and 
enlarged at its posterior extremity. 



WORMS. 301 

Fourth : The Tomia Solium or tape-worm. It is of a flat ribbon- 
like shape of from one-quarter to one-half an inch in width at the 
largest place, tapering down to a mere thread. It has a head and is 
made up of numerous joints and is from five to fifty feet in length. 
It is seldom that more than one worm exists in the same individual 
at the same time. It inhabits the small intestines. 

The round worm and pin worm are most frequently found, partic- 
ularly in children. Adults, however, do not escape, and many 
unpleasant feelings might be spared if they would occasionally 
direct their attention to the matter as a possible cause. We are not of 
the class who believe that everybody has worms, nor of the opposite 
school who believes nobody has them, or if present, they amount to 
nothing. In the treatment of chronic diseases we should be less suc- 
cessful if we entirely overlooked invermination. We could cite many 
cases, but one must suffice. A lady had dyspepsia for many years 
and no remedy seemed to benefit. We diagnosed lumbricoides but 
were surprised to learn that no visible effects followed the medication. 
A closer investigation only more strongly confirmed our opinions, 
and after a week's rest we gave an emetic with the result of dislodging 
three of the " oldest inhabitants." Their size and vitality astonished 
us. After a day's fasting we gave the chloroform and lavender mix- 
ture mentioned in several places in this w ork, and while the " happy 
family" rested in gentle slumbers cathartics carried them away and 
with them all symptoms of dyspepsia. Ten years ago a gentleman 
after ten weeks of typhoid fever, with professional attention and 
several consultations, was given up to die. A lobelia emetic broke 
up the fever (?) and the nest of p irasites and he is living to-day. 

The symptoms are mainly those of irritation of the stomach and 
bowels ; variable appetite, sometimes voracious, fetid breath, acid 
eructations and pains in the stomach ; grinding the teeth during 
sleep, picking the nose ; hardness and fullness of the abdomen, 
slimy stools with griping pains, short dry cough and emaciation. 
In children this irritation produces a feverish state and is popularly 
termed "worm fever." To these may be added a puffy or 



302 MEDICAL PRACTICE. 

bloated appearance of the face and a peculiar expression of the eyes. 
Under these circumstances the passages should be watched, and if 
worms or segments or joints are passed we are p< sitive of the diag- 
nosis. Otherwise we are not, for most of these symptoms attend 
the diseases we have mentioned. A physic will sooner settle the 
matter if there is no objection to its use. • 

TREATMENT. 

Being certain of the presence of worms and knowing the kind, 
their expulsion is not difficult. The fever or irritation in children is 
first to be treated by small doses of aconite or gelseminum, be- 
fore using a vermifuge. In the case of the long round worm or 
stomach worm, if they are accustomed to rise in the mouth or nose 
when sleeping, or to tickle the throat when laying down an emetic 
should besrin the treatment. We prefer the sulphate of zinc in doses 
from ten to twenty grains in a cup of warm water. Salt and warm 
water will drive them from the throat, but it is not so gcod as an 
emetic. After the emetic, or without it, if objection is made, 
1^. — Podophyllin, . . . . ten grain?, 
Santonine, .... one dram, 

Pulverized Sugar, . . . one ounce. 

Mix. 

Give five or ten grains every three hours. 
It requires no menstruum to disguise it as it is almost tasteless. 
After three days medication give a teaspoonful of calcined magnesia 
and in an hour a glass of lemonade In a few days begin the use 
of the santonine, follow for three days and repeat the physic. This 
plan should be continued for t- n or fifteen days at least. Only in 
this way can they be effectually destro} T ed and expelled. To guard 
against a second generation go Ihrough the same routine after the 
lapse of a month. Santonine is the most pleasant and effective 
remedy for the long round worm. It is the active ingredient of 
some worm lozenges ; it we thouuht a lozenge did not contain it or 
was made of other drugs we would not u e it — better make your 
own. 



TREATMENT OP WORMS. 303 

The same treatment will destroy the long thread worm. 

The pin worm we manage in a different way. It inhabits the 
lower bowel and may be reached by injections. It migrates from 
one to another between the warm sheets, and when discovered in a 
child the bed-fellows, whether young or old, should receive the 
same treatment at the same time. This consists of injections of car- 
bolic acid, ten to twenty drops, and warm water a pint, two or three 
times each day, particularly before retiring. The anus should be 
kept well oiled with lard or the antiseptic ointment. The import- 
ance of this will be better appreciated when it is understood that 
they seek the anus for propagation. By this means they are unable 
to deposit their eggs. Sheets and night clothes should be boiled 
daily. Give the calcined magnesia every night. This plan followed 
for three or four days will completely rid the patient of this pest and 
its intolerable itching and irritation. 

The tape worm is a more formidable adversary. The head is 
supplied with hooks and suckers and this we must have : portions 
or segments give no idea of the size of the animal, and their loss has 
little effect upon its life or the distress caused the patient. The 
segments grow from the head and push the others before them. A 
few inches may be lost every day for years, and yet a very long 
worm be expelled. The stomach and bowels must be prepared for the 
operation either by fasting ior twenty-four hours or by a physic at 
bed time and another upon rising. The remedy may then be pre- 
pared. The profession advise pomegranite, male fern, pumpkin 
seeds and kousso. Either one of them is good and if used properly 
will bring away the parasite. There is one difficulty, but this is 
easily met. We refer to the fact that the remedy is a fluid or given in 
fluid form, and may be absorbed before reaching and effecting the 
tinea. Hence alw T ays combine it with an active cathartic, such as 
the fluid extract of jalap in dram doses or croton oil in two drop 
doses. The simplest remedy is pumpkin seeds. Take off the hulls 
from a pint, pulverize and make into a mnsh with warm water. 
Salt to taste. Divide, add the cathartic and take one-half two hours 



304 MEDICAL PRACTICE. 

after the other. Male fern can be had in the form of oil. Dose a 
dram every two hours in hot milk, adding cathartic to each. A 
decoction of the pomegranite root is used in teacupful doses every 
two hours. It is disagreeable, but so is the parasite with whieh } r ou 
contend. Other remedies might bo mentioned, but we think we 
have pointed out relief for all. 

We want to say a few words upon another parasitical an mal 
which makes a host of us, if we extend the invitation to " walk into 
the parlor." We introduce it as the 

Pork or Sausage Poison. — Trichiniasis. 

No definite estimate can be formed of the frequency of this disease. 
So closdy docs it resemble oiher diseases and so seldom do physi- 
cians employ the microscope, if they possess one at all, that it easily 
escapes detection. An examination of the meat in an extensive 
slaughtering establishment found one specimen in every twenty five 
diseased. But millions of h<>gs are killed and packed yearly and we 
believe there is little cause for alarm. The high temperature reached 
in co' king destroys the germ : the sufferers have eaten the meat raw 
in the form of sausage or smoked ham. 

Upon microscopical examination of the meat worms only one- 
thirrieth of an inch in length will b : found scattered through it. This 
is the Trichina Spiralis, meaning curled hair, because it is coiled up in 
a cyst or sack. Upon entering t e human stomach these sacks are 
digested off and the parasites set free. They fa-ten upon the walls 
of the intestines and begin breeding. If the irritation is great and. 
the diarrhoea proportionate the chances of recovery are more favora- 
ble. At the end of the second week the }'oung appear in countless 
numbers and begin at once to burrow through the intestines and 
seek the voluntary muscles where they locate. The critical period 
with the afflicted is from the end of the first week when irritation 
begins to the end of the second week before reproduction recurs. 

The symptoms are not unlike those of typhoid fever or rheumatism: 



PORK PARASITES. 305 

nausea, loss of appetite, debility, soreness and stiffness of the muscle 
and pain increased by pressure, perspiration, tenderness over the ab- 
domen, diarrhoea. Later the muscular pains increase, the stools be- 
come bloody and have a peculiar odor, the power of swallowing, of 
speech and of breathing is lost. 

It does not require a very high power of the microscope to discover 
trichinae either in the hog or in the muscles upon post-mortem ex- 
amination. Great care, however, must be used in preparing the 
specimens. The section must be longitudinal and as thin as can be : 
treat with acetic acid to take out the coloring matter, wash thoroughly 
in pure water and mount in glycerine and water. 

TREATMENT. 

No direct medication has yet been discovered. When several mem- 
bers of a family are suddenly attacked with diarrhoea, if raw pork 
has been eaten this disease may be suspected. A microscopist will 
discover the parasite in the dejections and in the meat, if a specimen 
can be supplied. The diarrhoea should not be checked but in every 
way encouraged by free and copious draughts of mucilaginous and 
carbolized fluids and cathartics. This is the only relief the profes- 
sion can offer and this is of little avail after the end of the second 
week of their introduction. Upon the prevention of the malady we 
have more positive knowledge. The temperature of boiling water 
(212° F.) destroys the entozoa. The application is evident — always 
cook pork that is to be eaten. 

A List of Diseases classified as Parasitic but considered under 
other headings. 

Itch and Porrigo, in Class V, Diseases of Bone, Muscle and 
Skin, Order II, Skin Diseases. 

Thrush (Aptha), see page 407. 



306 MEDICAL PRACTICE. 



CLASS II CONSTITUTIONAL DISEASES. 



ORDER I. Diathetic Diseases. 



Rheumatism, Acute or Inflammatory. 

The disease is due to the presence of lactic acid in the blood. All 
secretions and excretions, even to the perspiration, give an acid 
reaction. The fever is high and the pain in some instances consid- 
erable. The larger joints, notably the knees, ankles and wrists are 
more frequently attacked. One joint only is involved at a time and 
the characteristic of the disease is that without premonition it may in 
a few hours centre upon another, leaving the first comparatively free. 
The joint attacked becomes red, hot, swollen, tender, and the least 
motion aggravates the pain. In some cases this sensitiveness is so 
great that touching the bed-clothes or walking across the floor will 
jar sufficiently to disturb the invalid. Pain is continually depicted 
upon the countenance. The invalid is restless, sleepless and thirsty, 
has a high fever, thickly coated tongue and deficient action of the kid- 
neys and of the skin. Occasionally there will be free perspiration hav- 
ing the characteristic sour odor. A peculiarity of inflammatory rheu- 
matism is that it expends its force upon the fibrous tissue. Sometimes 
the elbows, hips or shoulders are invaded. In this peculiarity lies its 
danger. The walls and the valves of the heart are fibrous. A change 
from a joint to this organ hazards life, while the heart being free 



ACUTE RHEUMATISM. 307 

from attack, there is little if any danger. In acute gonorrheal rheu- 
matism but one joint is invaded and the inflammation continues thus 
circumscribed until recovery. 

It is distinguished from dropsy in the joint by the latter resulting 
from an injury, having little swelling, never changing to other joints 
and by fluctuation of the contained fluid. Milk-leg occurs only after 
confinement, generally attacks but one leg, which becomes white, with 
tense corded veins, and the swelling involves the whole leg. Gout 
attacks the smaller joints, principally the great toe and seldom moves 
its location; both redness and pain are greater in gout than in rheu- 
matism. 

Tlie indications are to remove, as far as possible, the acid from the 
system; chemically neutralize that which remains ; to stop the fever 
and relieve pain in the joints. 

TREATMENT. 

For the first, mix cream of tartar, two drams and podophylliu two 
grains. Mix thoroughly and make four powders. Take one in mo- 
lasses every two hours till they operate. After the operation is some- 
what, subsided, place the patient between woollen blankets. Flannel 
underclothes are advantageous. The alcoholic vapor bath by means 
of hot bricks or by the rubber bag should be used and continued 
without intermission for a day or two. The body may be bathed 
under tlie bedclothes with soap and hot water. Soap is an antacid. To 
keep up chemical action and to quench thirst, put a teaspoonful of 
cream of tartar and of sugar in a glass of water and administer as a 
common drink. This acts gently upon the kidneys and bowels. 
Veratrum may be given in three or four drop doses every four hours. 
As a simple local application, flannels wrung out of hot water com- 
bined with soda or saleratus, may be wrapped around the painful joint. 
Or a liniment composed of 

1$. — Tincture of Aconite root, 

Tincture of Arnica flowers, and 

Laudanum, in equal parts, 



308 MEDICAL PRACTICE. 

May be poured upon a strip of fl-innel and bound around the joint. 
Too much reliance should n.-t be placed upon local tieatment, as it 
is pallative other than curative. 

A prescription of great value, and we believe to be indispensable, 
which acts upon the eliniinative organs and rerns to possess a spe- 
cific antagonism to lactic acid formation, is as follows: 
I£. — Spirits of Nitre, .... three dram-, 
Acetate of Potash, .... two drams, 
Tinct. Colchicum seeds, . four drams, 
Water, . three ounces, 

Essence of "Wintercreen, . one dram. 

Mix. 

Give a tcaspoonful every two or three hours. 

Morphine or opium may be given at night to secure sleep. In rare 

and ted.ous cases it may be necessary to repeat the podophyllin. 

Chronic Rheumatism. 

This disease appears in many form*. It may come on suddenly 
and be as speedily removed, may f How an acute attack of rheu- 
matic fever or m iy slowly develop and last for years. The princi- 
pal symptoms are pain, stiffness or difficulty of motion, soreness and 
perhaps dropsy. It differs from the acute form by not being 
attended with fever, by little if any redness or swelling and by being 
confined usually to a s-ingle part. Like all rheumatisms, ii attacks 
the fibrous tissue. This we find in the joints and sheaths or en- 
v( lopes of the muscles, the sheaths of the nerves, the ends of the mus- 
cles 1 y means of which a firm attachment is made to the bones, and 
in the valves of the heart. Occasionally the muscle or muscles are 
contracted, sometimes permanently. When the nerve sheaths are 
involved the symptoms are neuralgic. It more frequently afflicts 
the aged. 

It may settle in a part ; lumbago is chronic rheumatism of the 
back. Men working in a (stooping position which separates the 



CHRONIC RHEUMATISM. 309 

pants and vest over the spine, becoming overheated and exposed to a 
draught of cold air, are liable to lumbago. The back becomes stiff ; 
there is sharp pain on rising or walking ; it is only with great diffi- 
culty that the person can assume an erect position. Rheumatism of 
the broad muscle covering the forehead and crown of the head is 
often mistaken for headache. "When seated in the muscles of the 
neck, compelling the head lo be held at one side and towards the 
side affected, it is termed torticollis or wryneck. The eye and 
its muscles are sometimes assailed. The muscles covering the abdo- 
men, the muscles covering the chest or the muscles of the forearm 
and shoulder may be affected. The uterus is its favorite seat and it 
may be well to notice this fact before commencing treatment. One 
of the most painful locations is the hip joint and sciatic nerve. 
Sciatica is a disease so deeply seated, combines so closely the symp- 
toms of neuralgia and rheumatism, that it is quite difficult to reach 
and relieve it speedily. Another favorite seat is the valves of the 
heart. This is most dangerous because it involves and interferes 
with the circulation. Because the closure of these valves is not com- 
plete, the blood often regurgitates or flows backward. It is on 
account of the liability of rheumatism to change in location from 
some part to the heart and the consequent tendency of the disease 
to shorten life, that life insurance companies almost invariably refuse 
to take risks upon persons who have suffered from acute rheumatism, 
or who have for several years before the application, been troubled 
with the disease in its chronic form. 

The indications are to correct the acidity of the fluids, and by 
arousing the skin, liver and kidneys, accomplish its elimination ; to 
relieve pain, and if necessary change the occupation and improve the 
diet. 

TREATMENT. 

The first indications are met by the use of the Turkish bath, fre- 
quent bathing in water saturated with soda, or the soap and water 
sponge bath. So much for the skin. The antibilious pill and the 
spirits of nitre compound just given, will secure activity of the liver 



310 MEDICAL PRACTICE. 

and kidneys. A simpler, and we deem it as effective, a preparation, 
is the use of composition tea (Beach's), given warm upon retiring 
and taken cool once or twice in the mornings. An effective pre- 
scription and quite pleasant, is 

I£. — Simple Syrup, . four and one-half ounces, 

Tinct. Colchicum Seeds, one ounce, 
Tinct. Guaiac, . one ounce, 

Tinct. Opium, . one dram, 

Essence Wintergreen, two drams. 

Mix. 
Take a teaspoonful night and morning. If it moves the bowels 
too freely, either add a little more opium or diminish the dose. 
Thoroughly rubbing the part with antiseptic ointment will relieve 
pain and scatter inflammation. This is also the proper method for 
overcoming stiffness of the joints and contraction of the muscles. 
In deep-seated pains aud those of a neuralgic character the aconite 
and arnica liniment may be employed, or the hartshorn liniment. In 
the severe form of sciatica, morphine should be given either by the 
mouth or by hypodermic injection. In addition, may be passed into 
the bowel a mixture composed of 

B. — Turpentine Oil, . . . half an ounce, 
Castor Oil, .... half an ounce, 
Mucilage of Gum Arabic, . half an ounce, 
Camphor water, . . . one ounce. 

Mix. 
Administer every morning until relieved. 

These injections may irritate the bladder, but it will only be for a 
short time. The effect upon the many and large nerves leading 
toward the hip joint is so beneficial that this trifling disturbance can 
be overlooked. 

Thick flannels may be worn next the skin continually both sum- 
mer and winter. On becoming accustomed to their use it will be 
found that they are not only comfortable in winter, but not so bur- 
densome aud oppressive in summer as will be anticipated. The 



GOUT. 311 

patient should assure himself that the walls and floor of the bedroom 
are dry, and he should sleep between woollen blankets. The diet 
should be generous and with as little as possible of the common flour 
bread and other articles composed chiefly of starch. 

Recovery to a condition marked by absence of pain and local dis- 
comfort, should be followed by the occasional use of the Turkish 
bath and the employment of some tonic such as the Queen's root pill 
or syrup. 

Gout — Arthritis, Podagra. 

This constitutional condition may be hereditary or produced and 
acquired by want of exercise, and by what is known as high living, 
the use and abuse of strong wines, malt liquors and rich foods; The 
premonitory symptoms are indigestion, or, more properly, an acid 
dyspepsia with flatulence, constipation, scanty urine and palpitation 
of the heart, all of which are lessened by a fit of gout. The fit con- 
sists of swellings of some one of the small joints which suddenly 
becomes very tender and painful with a red and shining skin. It 
locates in the large toe chiefly, but may attack any of the toes, the 
fingers, wrists or ankles. The local difficulty lasts some three or 
four days and then subsides to reappear after an uncertain interval. 
Sometimes it is " driven in" by cold and attacks one of the larger 
organs of the system. There is a deficient oxydation of the blood, 
impaired action of the kidneys, the blood is saturated with uric acid 
and not uufrequently urate of soda is found on the surface. 

It ix distinguished from rheumatism (in their acute forms) by gout 
assailing the small joints, rheumatism the large; by uric acid in the 
former and lithic acid in the latter; in the former the joint is more 
painful, is oftener affected and sooner passes away; in the latter the 
joint is less painful, the attacks are less frequent and last longer; gout 
may produce palpitation of the heart; rheumatism engenders in- 
flammation. In gout, the stomach is disturbed; in rheumatism, 
hardly ever. Differentiating the chronic forms is not so easy and 



812 MEDICAL PRACTICE. 

much must be gained from the history of the case. Sometimes, but 
rarely in this country, we have the two combined — a rheumatic- 
gout. 

TREATMENT. 

The foot may be treated to a bath of hot water, to which is adde* I 
common soda or mustard. If this does not quiet the pain procure 
i^. — Tincture of Aconite root, 
Tincture of Arnica flowers, 
Laudanum, . . in equal parts. 

Mix. 
Use as a lotion, either bathing the joint or bandage with flannel 
and keep it wet. To neutralize the acid give teaspoonf ul doses of 
calcined magnesia every four hours, regulating the frequency by the 
strength and the movements. A most efficient means for its ejection 
is the Turkish or spirit vapor bath ; this we consider indispensable. 
To affect the kidneys, take 

1$. — Spirits of Nitre, three drams, 

Tincture of Colchicuin Seeds, 
Acetate of Potash, 
Essence of Wintergreen, 
Water, 



four drams, 
two drams, 
one dram, 
three ounces. 

Mix. 
Dose, a teaspoonful every two hours. Tonics should be employed 
after the acute symptoms have abated. The diet should be good 
and nutritious, but not rich and stimulating. Flannels should be worn 
and woolen stockings. If the feet are col 1 when going to bed use 
tbe rubber bag. Dusting a very little red pepper upon the inside of 
the sole of the stocking will keep the feet comfortable during the 
day if exercise is taken, and exercise is important to recovery. 

Blood lessness. — Aticemia. 

In this disease there is a deficiency of blood or a poverty of the 
red corpuscles of the blood which gives it color. It may re ult from 



BLOODLESSNESS. 313 

exhaustive diirrhoea, dysentery, hemorrhages of any kind, from de- 
bilitating fevers and diseases or from starvation. The pulse is rapid 
and feeble, appetite poor, with fainting, dropsies and usually amen- 
orrhea. The striking symptom is the pale and waxy appearance 
of the skin and mucous membranes. 

Leucocytluzmia is a name given by physicians to a species of 
anaemia in which the white blood corpuscles predominate the same as 
in the cold-blooded animals. The general appearances are the same 
as in anaemia and progressive emaciation is the general result. An 
exact knowledge of the presence of this disease can only be obtained 
by the microscope. In most cases the spleen is affected. It is 
sometimes called "pernicious anaemia." 

Addison's disease is another affection belonging to this group. 
The bloodlessness is well marked, and ihe languor, debility and pro- 
gressive emaciation also. The peculiarity is that instead of a waxy 
appearance, the skin has a sallow, yellowish or bronzed tint. The 
capsule of the kidney is diseased. 

TREATMENT. 

Hygienic means are of the utmost importance ; fresh air, proper 
exercise; nutritious f od with baths and friction. Iron in some form 
seems to be demanded by the poverty of red corpuscles, but this 
must be given in a form that is easily assimilated and that taxes the 
vitality the least. The bowels should be regulated by mild aper- 
ients and every means employed to invigorate the system and pre- 
serve iind augment the vitality. 

Green Sickness. — Chlorosis. 

This is an anaemic condition of young girls who have not menstru- 
ated or by whom this function is imperfectly performed. The com- 
mon name is given on account of the pale greenish-yellowish cast of 
the skin. They are easily fatigued, are averse to labor or exercise, 
prefer solitude, are cheerless and suffer from perversion and loss of 
appetite, impaired digestion and waste in flesh. Headache, constipa- 
tion, foul breath and palpitation may attend. 

14 ..-■ — 



814 MEDICAL PRACTICE. 

TREATMENT. 

In this disease as in the one just described there is a very mnrked 
deficiency of iron in the blood. The advice there given is equally 
applicable here. We would further sug2est that in addition to tlie 
administration of iron a uterine tonic may be given, and we know of 
none better than the Matrikonine. (See Uterine Diseases.) 

DROPSY. 

Dropsy is an accumulation of serum in the cellular tissues of the 
body or in some of its cavities. It is general or external, and local 
or limited to a single cavity. In general dropsy we notice an in- 
crease in the size of the part, without pain, redness or inflammation, 
the skin usually pale, stretched and ^hi.iing, and upon pre?sure by 
the end of ihe finger, unevenness of surface remains for some time, 
disappearing only when the fluid has returned and again infiltrated 
the tissue. This anasarca or general dropsy is particularly apparent 
in the bloating of the face, the tissue under the eyes and in the hands 
and feet. The local infiltration technically known as oedema is 
principally exhibited in the feet and, as the causative disease pro- 
gresses, advances up the limbs. 

Local dropsies occur in almost all of the sacs of the body. There 
is hydro-thorax or dropsy of the chest, such as false pleurisy; there 
is dropsy of the heart ; hydrocephalus, or dropsy of the brain accom- 
panying inflammation of that organ, spotted fever, etc. ; hydrocele, 
or dropsy of the testicle ; ovarian dropsy; ascites or dropsy of the 
abdomen, etc. 

The appearance of general dropsy is butan index of disea c e and 
not a disease in itself. For the cause we must look to either the kid- 
neys, the liver, or blood-vessels. "When from any cause, as disease 
of the kidneys or severe cold in which the skin is principally involved, 
excretion is interfered with and the fluids are retained, they find their 
way by force of gravity to the ankles. When disease of the liver is 
present, or there is pressure upon some of the larger veins, then from 
interference with the circulation serum accumulates in the lower 



DROPSY. 315 

limbs. With disease of the heart, there te imperfect circulation, and 
the same result may follow. A vitiated condition of the blood is one 
of the most frequent causes of dropsy. {Several of these causes may 
be at work at the same time, as in scarlet fever, where the blood is 
deteriorated, the h art enfeebled and the blood-vessels impaired. 
Again, dropsy may come on suddenly and it be impossible to attribute 
it to any definite cause. This latter yields readily to proper treat- 
ment and is seldom fatal. 

Hydrocephalus, or dropsy of the brain, occurs in children. The 
head increases greatly in size, with gradual loss of the mental faculties, 
Benses of smell, hearing, seeing, etc., and finally of motion. Fol- 
lowing these are epilepsy and palsy and possibly idiocy. Cardiac 
dropsy can only be detected by the physician. It usually follows an 
acute attack of inflammation of the heart and cannot be confounded 
with another disease which develops only gradually. 

The most frequent local dropsy is that of the abdomen. Whatever 
the cause may be, we find the head and neck presenting signs of 
emaciation while the belly becomes more prominent. After a while 
b is noticed that this prominence partly disappears upon assuming 
the recumbent position; also that it sags on the side on which the 
party reclines. Holding the hand again t the surface on one side 
and striking the other with the end of a finger, a wavy impulse is 
given which is distinctly recognized by the applied hand. These 
percussion strokes upon any part of the abdomen below the surface 
of the contnined fluid give a dull sound, while, on the contrary, if 
the bloating is due to confined gas, the sound is light and tympanitic. 

Abdominal dropsy is distinguislied from confined gas in the man- 
ner just described; besides, in the latter, there is no fluctuation; in 
ovarian dropsy the dullness on percussion may be confined to the 
side involved and a tympanitic sound be heard on the other; also the 
prominence is rather in front and not at the sides; from pregnancy, 
by the many physical signs attending the enlarging uterus, by the 
absence of fluctuation, by "quickening," and, if the stethoscope 
is employed, the sounds of the foetal heart; from distension of the 



816 MEDICAL PRACTICE. 

bladder, by tenderness upon pressure just above the pubic bone and 
by the fact that urine has been voided. 

Hydrocele, or dropsy of the testicle is accumulation of fluid in the 
tunic or membrane enclosing the testicle. It is a common malady, 
may be present at birth, or occur any time during life and attacks 
but one side. The swelling is first noticed at the lower part of the 
scrotum to which the water falls by force of gravity. The enlarge- 
ment is from below, upwards. In hernia, on the contrary, the 
swelling begins above and progresses downwards. The skin is af- j 
fected but little by the dropsy, although the tunic may contain as 
much as a pint of this colorless accumulation. It is translucent like 
an egg. Holding a light behind the scrotum in a dark room and looking 
through from the front will convince one that it contains no solid in 
its lower portion When the tunic fills with blood imtead of water, 
as from injury, it is known as Hematocele. 

Hydrocele is distinguished from cancer b} r the absence of excessive 
weight and great pain, also by the manner in which the swelling 
occurs. From general dropsy by its pendency at first, the latter 
having a more even distribution over the surface. A dropsy involv- 
ing both testicle and cord may be differentiated by placing the pa- 
tient upon his back and raising the hips, when the fluid will 
escape into the abdomen, returning upon his assuming the erect 
posture. 

Surgeons are in the habit of emptying the sac by puncturing it 
in its lower portion and allowing the water to escape. The testicle 
is then strapped to the pubic surface- by adhesive strips and the pa- 
tient kept in bed a week. Only in advanced stages, or in old chronic 
cases is this necessary. In all inflammatory conditions of this organ, 
support should be given by means of the suspensory bandage. This 
relieves pain and keeps the unusual weight from dragging upon the 
spermatic cord. When dropsy is suspected an elastic rubber bag 
lined with cottojj may be sprung over the scrotum; thereby pro- 
moting absorption of the fluid. As this is difficult of adjustment and 
occasions uneasiness, we prefer and advise a knitted scrotal supporter 



HYDROCELE. 



317 



provided with adjustable tapes which admit of increasing the ten- 
sion as the wearer- is able to bear it. 




Hydrothorax is an effusion accompanying pleurisy and will be 
considered at length under that head. As in abdominal dropsy, 
when the accumulation is extensive the surgeon is called upon to 
remove the fluid by puncturing the skin, or as the process is more 
generally called, by tapping. 

TREATMENT OF GENERAL DROPSY. 

Ihe indications in treatment are to remove the cause, either the " 
condition of the bloud or organic disease or both; to rid the i 



318 MEDICAL PRACTICE. 

of the superabundance of fluid. In respect to the conditions develop- 
ing drops}', the proper treatment will be presented when these con- 
ditions and diseases are separately considered. 

To remove the fluid we know no better means than the administra- 
tion of a decoction or tea made with queen-of-the-meadow root in 
the proportion of one ounce, steeped in one pint of water. This 
quantity should be taken daily and may be divided to please the 
invalid. Or 

I£. — Spirits of .Nitre three drams, 

Acetate of Potash two drams, 

Tr. Colchicum seeds, four drams, 

Water, three ounces, 

Essence Wintergreen, one dram. 

Mix. 

These are excellent diuretics, but to be effective and arouse the 
kidneys they must be absorbed. Where this process is defective the 
use of a hydrogogue cathartic is necessary to compel activity of the 
liver; causing watery stools, it also assists in removing the fluid. 
One-tenth of a grain of the resinoid of mandrake (podophyllin) thor- 
oughly triturated in one or two grains of sugar, magnesia or sugar 
of milk, may be taken every four hours, until free and thorough 
operation is produced. The Turkish bath or alcoholic sweat may be 
employed in the earlier stages and should be followed with thorough 
rubbing of tlie whole surface. 

As most dropsies depend upon watery blood, feeble blood-vessels 
and flabby heart, no treatment will be successful unless accompanied 
with the best tonics. The continual effort to remove the accumula- 
tions may have the very opposite effect, brought about principally by 
the use of remedies, good in themselves, but debilitating when ad- 
ministered too frequently or too freely. 

To obviate this untoward result, as soon as the kidneys are opera- 
ting well and the increased flow of urine is perceptible, the diuretic 
may be suspended for two or three days. The administration of an 
astringent will hasten the cure. Prescribe 



CANCERS. 319 

$.-— Tannin four drams, 

Port Wine, six ounces. 

Mix. 
Give a tablespoonful every hour. 
A mixture like the following is of value: 

]$. — Sulphate of Magnesia, . . . four drams, 

Sulphate of Iron, eight grains, 

Sulphate of Quinia, .... twelve grains. 
Dilute Sulphuric acid, . . . one and one-half drams. 

Mix and add 

Fluid ext. Ginger, two drams, 

Simple Syrup, one ounce, 

Water, eight ounces. 

Mix. 
Take two tablespoonfuls night and morning. 
This is both palatable and eifective. 

Cancer. — Carcinoma. 

This is one of the most distressing maladies with which the human 
family is afflicted. No part of the body, flesh or bone, seems to pos- 
sess immunity from its ravages. It occurs most frequently in the 
breast and womb of the female, and in the lip, stomach and testicle 
of the male. The causes are unknown. Prolonged irritation or 
wounds are thought to influence their inception, but such seems 
hardly probable, for innumerable are the irritations and injuries 
that have no such termination. That tomatoes have in any way the 
power of producing cancer is simply ridiculous and we would not 
mention it but for the fact that in certain localities such a notion is 
becoming popular. There is no foundation in fact for such an 
opinion. 

Cancers usually begin in lumps or hard tumors. They extend 
more or less rapidly in every direction, destroying or rather appro- 
priating the flesh as they proceed and finally open in the form of 
ulcers, discharging an irritating and very offensive matter. They 



MEDICAL PRACTICE. 



destroy life by emaciation, hemorrhage or destruction of vital organs. 
Dr. Howe in a communication to a medical journal vividly portrays 
the constitutional effects, thus: "A patient affected with cancer 
loses the glow and hue of robustitude and takes on a pinched, yellow- 
ish and sodden aspect. The nails show incurvation, as in phthisis; 
the superficial veins on the front aspect of the wrist appear to convey 
blood the color of reddish wine; the flesh wastes; chills and night 
sweats are experienced ; fever and restlessness come on ; the strength 
diminishes ; pain is felt in the local development ; faulty nutrition 
and anaemia become strikingly apparent ; and the presence of a fatal 
disease cannot fail to be recognized." 

Cancers are named from some peculiarity, as Scirrhus, hard ; En- 
cephaloid, brain-like; Colloid, glue-like; Lupus, wolf; Hsematodes, 
bloody ; Noli me tangere, touch me not, etc. Their nature may be 
recognized without much difficulty when they have commenced to 
ulcerate, the fetor is characteristic and exceedingly offensive; the 
surface is irregular, the color light and the edges turned out. Their 
liability to bleed is another symptom by which to distinguish them 
from the non-malignant ulcers. The differential diagnosis while in 
the form of tumors is less certain and satisfactory. For example, we 
will review one of the most common forms of the disease — cancer of 
the breast. ._, »_-.., 



The Cancer 

Attacks after the functional ac- 
tivity of the gland has ceased, 
after forty years of age, but 
may be earlier in single 
women. 

Begins at a point and rapidly 
dtvelopes. 

Becomes fixed to the parts be- 
neath and is immovable. 

Invariably causes retraction of 
the nipple. 



Other Tumors 
Attack during the functional 
activity. 



Often appear as multiple tumors 

in one or both breasts. 
Are almost always movable. 

Sometimes cause retraction of 
the nipple. 



CANCERS. 



321 



The Cancer 
eats away and pene- 
trates. 

Soon involves the skin and ul- 
cerates; the edges of the open- 
ing appearing thickened, 
hardened and everted. 

Has a bloody and scanty dis- 
charge. 

Is accompanied with neuralgic 
pains down the side and arm. 

The glands in the arm-pit swell 
and inflame. 

Terminates within three years. 



Other Tumors 
Seldom involve the gland to any 

great extent. 
Rupture the skin by over-dis- 
tention and then only at a 
late period of the disease. 



Have viscid and abundant or 

watery and purulent discharge. 
Have no neuralgic pains in side 

and arm. 
Rarely involve the glands in 

the arm-pit. 
May develop for years, causing 

local distress only. 

"We have followed the comparison to its completion. In cancer of 
the womb there is throbbing in this organ, pains in the back and 
groin and running down the thighs, frequent losses of blood and irri- 
tative fetid discharges. 

In all forms of this malady there is pain, dull and aching at first, 
and only occasional ; later, sharp and darting like the thrust of a 
needle and in the last stages, severe and continuous. 

Soft cancers are more malignant than the scirrlms variety. The 
latter seem to derive nourishment from the tissues, the former from 
the blood. The blood-vessels in their vicinity are very large and well 
marked and hemorrhage,- when it does occur, is profuse, exhaust- 
ive or fatal. Their average duration is but half that of the dense 
carcinoma. 

Surface cancers (lupus), locate upon the cheek, lip, nose, back or 
shoulders. Commencing in either of the various forms of wart, pim- 
ple, blister, scabbed sore, or miniature tumor, in course of time the 
malignant ulcer appears. The sore is painful, fiery-red, with hard 
purplish margin and the offensive discharge. It spreads in all direc- 
tions, limiting its ravages to the surface only. The danger of annoy- 
14* 



823 MEDICAL PRACTICE. 

ing or disturbing the *• wolf " in its incipiency, is aptly expressed in 
its other name, " touch me not. " 

The deep-seated cancers which reach the surface seem not to be so 
much dreaded by the physician as the secondary conditions which 
follow interference with the local tumor or the absorption of its 
poison-cells into the circulation of blood. The lungs or liver are then 
likely to be involved. Fortunately for the sufferers this does not in- 
variably occur. The removal of the hard tumor or the open ulcer in 
its first stages with any swollen glands, will militate against such a 
result. 

TREATMENT. 

That " cancer is incurable," has passed into an axiom. The assur- 
ance with which quacks and pretenders claim to cure this terrible 
malady is remarkable. We do not recall a disease in which the advice 
of a well-educated regular physician and surgeon is of more impor- 
tance. In some instances the cancerous mass may be removed and 
the attendant ulcer healed, but the systemic recuperation associated 
with real recovery falls short. It breaks out in new places and leaves 
the victim to perish with deep-seated disturbances. The difficulty 
lies in the fact that the morbid growth is not enclosed in a capsule 
like a tumor or abscess but infiltrates through the flesh and is partly 
taken up by the absorbent vessels so that the extinguishment of the 
local manifestation is wanting in completeness. As bad as this may 
appear the removal is often followed by years of apparent immunity 
from disease and tolerably fair health; besides the absence of pain 
and sleeplessness which tells so upon the vitality, is an advantage. 
The dread of the surgeon's knife seems to be innate. With a better 
knowledge of the value of anaesthesia by chloroform or ether, this 
feeling will become modified or disappear altogether. A tumor of 
rapid growth or one suspected of being cancerous, should be taken 
away. 

For the open cancer, perhaps the best treatment is by caustics 
locally and the administration of powerful tonics and anti-scrofulous 
remedies. The "cancer doctors" confine themselves to topical ap- 



CANCERS. 323 

plications, which are supposed to be "secret." Occasionally they 
come to light and the " purely vegetable " mess is found to contain 
arsenic or to consist of drugs recommended in medical literature. 
One of these has been furnished by Dr. Ford. 

1$. — Gum Tragacanth, .... one dram, 
Gum Opium, .... two drams, 

Peroxide of Iron, .... three drams, 
Pulverized ArseniousAcid, . . thirty grains. 

Mix, using sufficient water to form a paste, spread on leather and 
apply. 

The ingredients are incompatible. If the system is not poisoned 
by the arsenic, the cancer may give way and heal, but the consti- 
tution is still tainted. The symptoms of poisoning are puffiness of 
the eyelids and fullness of the abdomen. A "specialist" uses 
chloride of zinc, flour and water, to form a paste. This is dangerous 
in the hands of the inexperienced, burning the flesh severely. White 
vitriol (sulphate of zinc) is caustic but milder. 

Applications to be effective must have an affinity for albumen and 
exceed the rapidity of growth in their destructibility; they should be 
antiseptic. A paste, as good as any, and one which may be used 
in the household, consists of the inspissated juices of poke leaves 
and sheep sorrel, in equal quantities. 

We have an opinion that if ever a specific is found for this disease 
it will be of the nature of carbolic acid. In open ulcer, whether 
benign or malignant, this does well, and we shall continue its use 
until a better is discovered. With a syringe we freely wash out the 
cavity three or four times daily with a solution of one part of the 
acid to thirty parts of warm soft water. After each washing a pledget 
of cotton thoroughly wet in a mixture of carbolic acid one part, 
and glycerine twenty parts, is applied, gently pressing to the base. 
In addition to '.he remedies indicated in each case, we prescribe three 
drop doses of the acid in syrup or water, three times a day. The 
fetor is thereby destroyed, the pain relieved, the growth arrested, and 



824 MEDICAL PRACTICE. 

the cancer may succumb. In cancer of the womb, the pledget is 
passed to its place through a speculum or tube and the vagina is fre- 
quently smeared with the antiseptic ointment to prevent the escaping 
fluids producing inflammation or erosion. 

Pain is the distressing symptom in carcinoma, but it should be 
borne, if possible, during the day, and opiates given at night to se- 
cure sleep. When recovery is doubtful or the case hopeless, mor- 
phine may be used continuously. * 

The time was when the results of treatment were interpreted: " If 
it was cured, it was not a cancer;" or, "If it was not cured, it was 
of course, a cancer." The microscope now settles the diagnosis. 
That cancer is sometimes curable, we know. We have for years had* 
under critical observation, the labors of an eminent physician in this 
city, and we can certify that sometimes his cures are remarkable. 






BRAIN INFLAMMATION. 



CLASS III. LOCAL DISEASES. 



ORDER I. — Diseases of the Brain and General Nervous 
System. 



Inflammation of the Brain, Brain Fever, 
Fren z y. — Phrenitis, Meningitis. 

The inflammation may be confined to the substance of the brain or 
its coverings, but this is of no practical value, as there is but little 
distinction bet ween the two. It may be brought about by violent 
mental emotions, by sun heat, by injuries, or by inebriation, but is 
not frequent, and is met oftener as typhus fever or as a complication 
or sequence of other fevers. The marked feature is a strong tend- 
ency of blood towards the head. Quinine, opium and morphine, 
have a similar tendency, and are in this condition injurious and often 
fatal. The symptoms are high fever, hard and rapid pulse, head- 
ache, incr- asingin severity, flushed face and eyes, contracted pupil, 
coated tongue, ringing in the ears and intolerance of light and sound. 
The patient is irritable and sleepless, and, in the earlier- stages, we 
have violent delirium, afterward low and muttering, with jerking of 
the tendons, picking at the bed clothes, gradually lapsing into insen- 
sibility and coma. 

treatment. 

Occurring in children, we are limited to the use of cold packs to 
the head, the spirit vapor bath, sponging the body with cool water 



330 MEDICAL PRACTICE. 

while the temperature is high, and the use of gelseminum or bella- 
donna in small doses. In the adult, we follow a plan about like 
this : 

I£. — Podophyllin, .... two grains, 
Cream of Tartar, . . . two ounces. 

Mix. 
Triturate thoroughly and divide into four powders. Take one in 
syrup every two hours till the bowels move freely. In some violent 
cases this has restored consciousness. Have the house quiet. If the 
stomach is irritable apply a mustard paste over the region of this 
organ. Give internally the tincture ot'veratrum viride in two or 
three drop doses, every hour or two. Use the spirit vapor bath or 
sponge the surface with cool water. Seldom do we see the need of 
mustard paste to the feet and nape of the neck, but would use them 
when indicated. 

Spotted Fever. — Cerebrospinal Meningitis. 

This disease is chiefly epidemic and centres, as its name implies, 
upon the meninges or coverings of the brain and spinal cord. While 
other fevers may be traced directly to miasm, defective drainage, 
impurities in drinking-water, sewer gases, etc., the specific poison in 
this disease has not been discovered. It prevails in circumscribed 
localities, but makes no exception on account of any care or precau- 
tion taken in reference to preserving the best sanitary conditions. It 
also attacks the young and vigorous as well as the scrofulous, debili- 
tated or infirm. In its more violent form it is contagious. In the 
cerebral type the brain symptoms are the most prominent, commen- 
cing with dizziness and headache and progressing with the fever, 
until delirium or spasms follow. Nausea and vomiting are present 
and accompany any motion of the head. There is a sinking sensa- 
tion at the pit of the stomach, great prostration, pain in the spine and 
limbs and an acute sensitiveness of the skin, which is painful upon 
pressure. The characteristic sign of the disease which is developed 



SPOTTED FEVER. 331 

later, is the spasm of the back by which it permanently curves for- 
ward and by which the head is thrown backward as far as possible 
and there kept. The attacks vary ; in some delirium and other of the 
worst features of the disease develop in the first day or two; in others 
the fever may not reach its height in a week; some recover within ten 
, days, and in others convalescence is protracted weeks, perhaps 
months. So with the peculiar eruption which gives to it its name: 
it may appear upon the first, second or third day, or hV may be en- 
tirely absent. This varies also in character, color and position; 
closely resembling flea-bites and ranging from scarlet to brown. 
When the disease is of long duration, there may be almost complete 
loss of muscular power, also blindness or deafness, insanity, idiocy 
and softening of the bra : n. The bowels are at the first constipate. 1, 
but may run into eliarrhcea. The bladder is troublesome from the 
tendency to retain urine. 

It is distinguisliecl from typhoid fever by the violence of the attack, 
the brain being so speedily overcome by the sudden prostration, 
while in typhoid the person may be ailing for days before being com- 
pelled to go to bed. In cerebro-spinal meningitis the pulse is much 
slower and the temperature of the body rises but little. There is pain 
in the head and back, the head is bent backward, and firmly held in 
this position. These last symptoms will also distinguish it from ty- 
phus. In lockjaw the muscles are rigid, and there is an absence of 
delirium, but consciousness continue s to the end. 

The indications are to relieve the inflammation in the cerebral mem- 
branes, to prevent effusion or if it has occured. to promote absorp- 
tion, to neutralize the blood-poison, to relieve the pain in the spine 
and back of the head and the rigidity of the muscles of the back and 
to tone up the system during prostration. 

TREATMENT. 

The first indication is met by administering 

Vf. — Veratrum Viride, . . forty-eight to eighty drops, 
Water, .... sixteen teaspoonfuls. 



332 MEDICAL PRACTICE. 

Dose : a teaspoonful every four hours. 
Two hours after each dose of this mixture give a teaspoonful of 
the following: 

I?. — Tinct. Belladonna, . . forty-eight to eighty drops, 
Water, .... sixtt en teaspoonfuls. 

Mix. 
This tends to equalize the circulation and to contract the peripheral 
blood-vessels and iu so far as it is successful, to such an extent is the 
local inflammation abated. The second point is met b} r giving 

^. — Podophyllin, two grains, 

Cream of Tartar, . . . . . two drams. 

Mix thoroughly, divide into four and give one every four hours in 
syrup, repeating until followed by copious watery discharges from 
the bowels, then stop. There is no griping and no irritation of the 
alimentary canal. If nausea or vomiting are present, precede the 
administration of this remedy with the application of mustard paste 
over the region of the stomach until the surface is well reddened. 
Of the greatest importance in this particular is the use of the spirit 
vapor bath by means of the rubber bag filled wiih hot water. Free 
perspiration causes the further elimination of fluid and with it 
the blood-poison, and by its effect upon the circulation removes to 
some extent the fever and meningitis. The third point is < overed 
by the two just mentioned. The pain in the head and the sensitive- 
ness discovered along the spine upon pressure yield kindly to fre- 
quent bathing with the aconite liniment, which consists of 
1$. — Tinct. Aconite root, 
Tinct. Arnica flowers, 
Laudanum, . . ... equal parts. 

When convenient, a long, narrow strip of flannel may be saturated 
with it and applied tc-the spine and a piece of oil-silk placed between 
the flannel and the clothing. At the back of the neck the silk lies 
betweeen the flannel and the pillow. The best tonic in all cases is 
good food, but to be of benefit, it must be digested and absorbed. 



CONCUSSION OF THE BRAIN. 333 

In this as in other diseases in which the nervous system is debilitated, 
the supply of nervous stimulus to the stomach is deficient if not 
altogether wanting. Warm milk, milk porridge, beef-tea are valua- 
ble, but should be given only in small quantities. If the patient 
desires, it may be frequently repeated. It is fashionable to stimulate, 
but it seems neither reasonable nor scientific to use alcohol in any 
form when the brain is affected. 

I?. — Tinct. Nux Vomica, . . . ten drops, 

Water, . . . . . . half a tumblerful. 

Mix. 
Give a teaspoonful every four hours. During prostration and 
convalescence alternate with this by administering two hours after 
each dose, a teaspoonful of 

1$. — Dil. Phosphoric acid, . . one dram, 

Water, . . . . . a half- tumblerful. 

These give strength to both muscles and nerves, increasing in their 
power and benefits while employed, and they are followed by none 
of the deleterious effects of alcohol noted more particularly when thij 
agent is discontinued. If upon examination the bladder is discov 
ered to be full and urine is retained or only dribbles away, apply j 
hot pack upon which spirits of camphor has been sprinkled, over th« 
lower part of the abdomen. 

Concussion of the Brain. 

From external injuries or blows as in falling from a height or having 
some weighty substance strike the head, the brain and nervous cen- 
tres are shocked. Unconsciousness succeeds immediately and may 
be more or less protracted according to the amount of internal dis- 
turbance. When simply stunned, the person will recover his senses 
in a short time and be able to stand and w;ilk. Not so if the shock 
has been severe. The comatose condition continues, the breathing is 
labored, pupils contracted and pulse weak and irregular. If not 



834 MEDICAL PRACTICE. 

revived the insensibility becomes deeper, the surface cold, dissolution 
approaches. In recovery from this condition, consciousness slowly 
returns and the power of motion still more tardily, consuming hours 
or days in its completion. 

Shock or stun is but one effect; there are other and more serious 
complications. The blow may have been so heavy as to rupture a 
blood vessel, when the symptoms of apoplexy supervene. Or the 
skull may be fractured and a spicula of bone press upon the cerebral 
mass, a condition known as compression of the brain. The symp- 
toms are still apoplectic; unconsciousness, jerky, noisy breathing, 
nausea and vomiting. 

It is distinguished from other comatose conditions in the manner 
described when we come to speak of coma. 

TREATMENT. 

In concussion of the brain the object should be to restore as speed- 
ily as possible to the brain its lost stimulus, the blood. The body 
should be placed at an angle of 45°, with the hips elevated and the 
head dependent. Sprinkle water on the face and apply to the nos- 
rils hartshorn (smelling salts). The bowels may be injected with 
two to four teaspomful< of brandy or whisky in a cupful of warm 
water. Compression must be relieved by the surgeon's aid, the 
citheter used to evacuate the bladder, and injections for consti- 
pation. 

Sunstroke — Coupde Soleil. 

This condition is caused by exposure either to the direct rays of 
the sun or to an intensely heated atmosphere. The brain becomes 
congested and its membranes inflamed, or the lungs are congested, 
or there is nervous exhaustion with failure of the heart. The skin is 
hot and dry, the pulse quick and feeble, the face flushed or pale, the 
tongue red or brown, the pupi's contracted, the eyes bloodshot, the 
vision dim, the breathing difficult, and the evacuations involuntary. 
The attack is preceded by dullness, headache, and a general feeling 



SUNSTROKE. 335 

of nneasinrss; even these are sometimes wanting and the patient falls 
suddenly and expires. However mi:d the stroke it is not unattended 
with danger, and for years afterward the patient is easily overcome 
by heat during the summer, by walking or working in the sun, (.spe- 
cially if fatigued. 

Insolation can usually be prevented by the constant application of 
cold to the head. Persons exposed to a scorching sun should wear 
in their hats a sponge, handkerchief, or large plant leaf, which ought 
to be ferquently w<t, and, as a further precaution, should avoid the 
use of large draughts of cold water or spirituous drinks. 

Over and over again in India the immunity from sunstroke enjoyed 
by temperate men has been observed. It may be interesting to re- 
count Sir Charles Napier's dc scription of his personal seizure while 
serving in India: "I had hardly," writes Sir Charles, "written the 
above sentence, when I was tumbled over with heat apoplexy; forty- 
three others were struck, all Europeans, and all died within three 
hours, except nr self. I do not drink. That is the secret. The sun 
had no ally in liquor in my brain." 

It is distinguished from apoplexy by fcble, not full pulse, by less 
complete insensibility, it being often possible to arouse the invalid by 
sp-aking in a loud voice, by dizziness and feebleness of motion, but 
not paralysis. In most instances sunstroke is attended with head- 
ache, apoplexy seldom. 

Tlie indications are to relieve the congestion of the brain when the 
face is Hushed and the superficial veins prominent, or when the face 
is pale and the symptoms of exhaustion predominate to stimulate 
ihe n< rvous .system. 

TREATMENT. 

As just obscved, t e plan varies with the condition pr rented. In 
the former case, that of* congestion of the head, the patient should be 
laid upon the b:ick, the body so inclined that the leet are lower than 
the head. Clothing about the neck should be loosened and cool 
water frequently poured upon the head and occasionally upon the 



336 MEDICAL PRACTICE. 

neck and upper chest. Give no remedies internally. If there is 
nausea apply a mustard paste over the stomach. If additional means 
an- thought necessary, bands may be tied around the thighs close to 
the body sufficiently tight to cause the veins of the legs to swell. 
This imprisons so much blood, and besides keeping it from doing 
damage to the brain or lungs, preserves the vital fluid for future use. 
As convalesence progresses these may be gradually slackened. If the 
invalid shivers, the application of water should be discontinued and 
plenty of warm coverings supplied. Sleep soon follows. 

In the other condition, if the patient can swallow, give a teaspoon- 
f ul every ten or fifteen minuies of 

B. — Brandy, four ounces, 

Tincture of Capsicum, . . . one-half ounce. 

Mix. 

Or, which is preferable, of 

1$. — Compound Spirits of Lavender, . . two ounces, 

Chloroform, two drams. 

Mix. 
If swallowing is difficult or impossible, the doses may be mixed 
with water and administered by enema. Apply cold water or ice to 
the spine. Rub ihe arms and legs to help the circulation, bathing 
them occasionally in cayenne pepper tea. 

Veratrum viride and aconite are the remedies to combat the fever 
that follows. When this has subsided, a tonic should be used, prefer- 
ably 

Ifc. — Phosphorus, .... one grain, 

Extract of Nux Vomica. . . twenty-five grains. 

Mix. 

Make one hundred pills. Dose taken after meals ; beginning with 

one pill daily and increasing to three daily, if required. 

Headache. — Cephalalgia, Uemicrania. 

He e again we have a symptom of a disease rather than a disease 
itself. It is as often due to a disorder in other organs as in the brain 



HEADACHES. 337 

itself. Headaches vary as much in character as in cause ; the pain 
may be sharp, lancinatiug, dull, throbbing, light or intense, may 
affect one part of the head, several parts or the whole, may be con- 
tinuous, as in diseases or tumor of the brain, or periodica!, which is 
the more common form. The latter are less dangerous and more 
susceptible to treatment. Headaches are, in some families, heredi- 
tary. Disorders of the stomach, bowels, liver, womb and nervous 
system, are the most frequent causes. Slight headaches happen 
more or less frequently to everybody. 

The popular names given to the different kinds of headache are 
used indiscriminately. What one calls nervous headache another 
calls sick headache; besides, either one or the other may be en- 
tirely misnamed and be either congestive or dyspeptic headache. 
We will endeavor to describe them by names which are more accu- 
rate or by which they are more commonly designated by the intel- 
ligent. 

In dyspeptic headache we have chilliness, cold feet, flushed face, hot 
forehead, dull pain in the front or sides of the head, furred tongue, 
loss of appetite, dry skin, nausea and vomiting. It seems as though one 
would go crazy or the head would split open. Bowels may be con- 
stipated, although irritation may exist in the stomach and the bowels 
continue to move. May be accompanied with neuralgia. 

Sick headacJie is similar in character and.differs only in the character 
of the pain, which is sudden, sharp and piercing at times. It in- 
creases in severity up to and through the nausea and vomiting, which 
latter seem to be an effort of nature to rid the system of irritation, 
open the secretions and equalize the circulation. The bowels are 
more likely to be constipated in this form. 

Nervous headache closely resembles sick headache. It is an affec- 
tion of the feeble, debilitated and brain-working classes. Females 
suffer most frequently. They are subject to attacks upon nervous 
excitement, excess* s, shopping, and it is a symptom of uterine dis- 
ease. There is dizziness, sharp pains and constipation. With rest 
and fasting it passes off. In the hysterical we have a kind of ner- 
15 



338 MEDICAL PRACTICE. 

vous headache termed by physicians clavus, which is the Latin for nail, 
because the pain is intense and confined to one spot, as though a nail 
was driven into the brain. 

Neuralgic lieadaclie is a species of nervous headache. It is a type 
found in the delicate, asthenic and enfeebled. The paroxysms are 
periodical and may last for years. The subject is afflicted with neu- 
ralgia in other parts of the body. The pains are sudden and darting, 
and may pass lo the face or run along the jaws. Decayed teeth may 
be the cause. 

Rheumatic and Gouty headache has little or no heat in the head, the 
pulse is seldom disturbed, and the pain is sometimes relieved 
by pressure. The urine will be found scanty and high-colored. 
The structure of one of the coverings of the brain is of that 
peculiar character in which rheumatism becomes seated. Rheu- 
matic pains are felt in other parts of the body, and usually the sick 
has had acute rheumatism. Such being the case, and the symptoms 
corroborating, the headache maybe suspected to be rheumatic. In- 
activity or congestion of the kidneys, which produces scanty and 
high-colored urine, may give rise to headache closely resembling the 
rheumatic variety. Dull pain and lameness of the small of the back 
are associated with this condition. 

Bilious lieadache is like sick headache, but there is a jaundiced hue 
of the skin, the tongue is coated yellow, and there is a bitter taste in 
the mouth. Nausea, vomiting and diarrhoea follow. 

Congestive lieadache is a species not so familiar, but exceedingly 
common. It is not so easily distinguished, because of its appearing 
in two forms which in appearance differ widely. In one the face is 
red and flushed, in the oth ,j r pale. In both there is an abnormal ten- 
dency of blood to the head. When the arteries are congested the 
former appearance prevails; when the veins are filled and sluggishly 
return the blood to the heart, the patient is pale. Both may result 
Irom stooping, fatigue, exposure to the sun, etc. In one the pulse is 
hard, face flushed, eyes suffused. The opposite is oftener met in 
those of spare habit. The face is pallid, eyes dull, pupils of the eyes 



HEADACHES. 339 

dilated, extremities cold, and pulse soft and feeble. The sensation 
is described as a cord tightly bound ^around the head. 

TREATMENT. 

Of course, this will vary with the character of the disease, and we 
can only in a general way indicate remedies for special conditions. 
We have cured headaches that have lasted for years, but only by the 
employment of medicines pure and unadulterated. This point we 
emphasize here on account of its importance. In another place we 
shall consider the matter at length. 

The indications are to frustrate the attack, relieve the pain if it en- 
sues, and afterwards remove the cause, or place the system in such a 
condition as to withstand the morbid influence. 

Upon the first appearance of the approach of dyspeptic or sick 
headache, 

1$. — Fluid Extract of Rhubarb, . . one dram, 

Brandy, two drams, 

Essence of Spearmint, . . . thirty drops, 

Bicarbonate of Soda, .... one dram, 

Simple Syrup, four ounces. 

Mix. 

Take a teaspoon ml every hour, or a teaspoonf ul of calcined mag- 
nesia may be taken in sweetened water or milk every hour for three 
or four doses. In bilious headache we prefer 

"Ef— Podophyllin, two grains, 

Cream of Tartar, . . . . two drams. 

Mix. 
Make four powders and take one every hour, in molasses. In ner- 
vous headache from excitement or fatigue, 

I£.— Chloroform, one dram, 

Comp Spirits of Lavender, . . one ounce. 
I Mix. 

A teaspoonf ul every hour will generally relieve by the third or 
fourth dose. 
Opium in any form should not be used for the relief of the pain of 



340 MEDICAL PRACTICE. 

headache, as its tendency is toward the head and it congests the blood- 
vessels of the brain. If the head is hot apply cold compresses to the 
hea 1 and a mustard paste to Ihe back of the neck. If the feet are 
cold put them in hot water or retire and take a spirit vapor bath with 
the rubber bag. In my own experience I have frequently stopped a 
severe headache in fifteen minutes by this means alone. I believe 
that one of the most pleasurable sensations to which the system is 
susceptible is the feeling of a severe headache gradually and surely 
departing. J confess personally to none greater. 

In the nervous, neuralgic and one form of the congestive species 
we rely upon 

I}. — Tincture of Gelseminum, (green root) . one ounce, 
Essence of Wintergreen. . . . one dram, 

Water or Simple Syrup, .... four ounces. 

Mix. 
Take a teaspoonful every hour until the pain abates. Better lay 
down for several hours after the third or fourth dose, on account of 
the rel txation produced by the remedy. 

In that form of congestive headache which is accompanied with 
pallid face, dull eyes, dilated pupil, etc., give 

~2r. — Extract of Belladonna, . . . three grains. 

Make twelve pills and give one every hour. Three to six are suffi- 
cient. Rest while the narcotic effect lasts. This article must be 
pure and we recommend the imported English extract, that you 
know to be such. Belladonna contracts the bloodvessels of the 
brain, opium h s the opposite effect This and the gelseminum are 
my standard remedies in all headaches and may be alternated with 
other remedies that may be employed, some of which we will pres- 
ently indicate. 

In general then, see that the stomach is alkaline, that the bowels are 
freely opened, that the skin is moist and the circulation normal. 
Attention should in all cases be given to the quantity and color of the 
urine. If scanty and dark-colored, as generally in rheumatic head- 
ache, take 



SLEEPLESSNESS. 



341 



E. — Tincture of Colcbicum, 
Spirits of Nitre, . 
Acetate of Potash, 
Essence of Wintergreen, 
Water, .... 



. four drams, 
. three drams, 
. two drams, 
. one dram, 
. three ounces. 
Mix. 
Take a teaspoonful every two, three or four hours. . Sometimes 
the bowels fail to act, in which case give some preparation of Golden 
seal to tone them up. The system must be rid of rheumatism, gout, 
liver and stomach difficulties, malaria, neuralgia and other inherent 
complications or the headache will recur. A good point is gained 
by breaking up the periodicity by one of the means above mentioned. 
While headache may thus be relieved and its duration shortened, the 
object should be to remove the foundation upon which it develops. 

Sleeplessness. 

This is hardly a disease of itself. It follows fevers, excesses of 
different kinds and accompanies general debility and many chronic 
diseases. Even in acute diseases, such as acute inflammation of the 
lungs win re coughing would only increase the irritation and in diar- 
rhoea and d} r sentery where wakefulness would still further disturb 
the bowels, there is in a majority of cases, a demand for some nar- 
cotic that will insure a night's rest. "Balmy sleep" is "nature's 
sweet restorer. " Opium is wanted, but we dislike its use from the 
fart that it constipates; besides it cannot be relied upon as a nervine. 
Valerian is sometimes good, but there is a tendency to irritate the 
stomach and bow« Is. A combination like the following will meet 
every particular and obviate all deleterious effects. 



$.— Tinct. Valerian (English), 
Calcined Magnesia, 
Tinct. Opium, 
Peppermint Water, . 
Oil of Anise, . 



one fluid ounce, 
two drams, 
one fluid dram, 
three fluid ounces, 
twenty to forty drops. 
Mix. 



342 MEDICAL PRACTICE. 

Shake well and take a teaspoonful upon retiring as often as neces- 
sary. This recipe is good also in hysterical cases and any case 
where exhaustion has followed want of sleep, and for females at the 
turn of life, for coughing in lung diseases acute or chronic, and in 
recovering from fevers in addition to the treatment elsewhere indi- 
cated in such cases. 

Where the brain is active, from fatigue or excitement, bromide of 
sodium may by given dissolved in water. It is an efficient and harm- 
less remedy, being followed by no unpleasant or detrimental effects. 
Or the feet may be soaked in hot water before retiring or the hot 
water bag placed at the feet. This calls the blood away from the 
head. A bowl of bread and milk at bedtime docs well with some : 
persons in literaiy pursuits after hours of restlessness have returned 
to bed after a lunch and slept soundly. 

Nightmare. — Incubus. 

From the common and the medical terms we get the idea of a 
hag or demon, representing night, lying upon the chest, and this 
comes closely to a description of our feelings, an oppression of 'the 
chest. Dunglison thus defines it: "A sensation of a distressing 
weight at the epigastrium (pit of the stomach) during sleep, and an 
impossibility of motion, speech or respiration ; the patient at length 
awaking in terror, after extreme anxiety. Nightmare is often the 
effect of difficult digestion, or of an uneasy position of the body. At 
other times it recurs in consequence of severe emotions. The sensa- 
tion of suffocation was formerly ascribed to the person's being pos- 
sessed, and the male spirits were called incubes, the female mccubes. 
The disease requires no particular treatment; the causes must be 
avoided. 

" Daymare is produced during wakefulness ; the sense of pressure 
being severe and exteneling over the abdomeu ; respiration frequent, 
laborious and constricted ; eyes fixed ; sighing deep and violent ; in- 
tellect undisturbed." This form of nervous disorder is rare. 



DKEAMING. 343 

Dreaming is a partial activity of tbe mind in disturbed or unsound 
sleep. In sound and healthy sleep all the faculties of the mind and 
the muscles and organs under the control of the will are at rest. In 
dreaming, the will, judgment and perceptions maybe inactive, and 
the imagination active, and sometimes the memory. It follows indi- 
gestion, excitement, worry, etc. Some men have done really hard 
mental work while asleep. Condorcc t finished a train of calculations 
in his sleep, which had much puzzled him during the day. In 1856 a 
collegian noticed the peculiarities of a fellow-student, who was rather 
stupid than otherwise during his waking hours, but who got through 
some excellent work in geometry and algebra during sleep. Condil- 
lac and Franklin both worked correctly during some of their sleep- 
ing hours. 

The work done, partakes in many cases more of the nature of imagin- 
ative composition than of scientific calculation. Thus, a stanza of excel- 
lent verse is in print which Sir John Herschel is said to have composed 
while asleep and to have recollected when he awoke. Goethe often 
set down on paper, during the day, the thoughts and ideas which had 
presented themselves to him during sleep on the preceding night. A 
gentleman one night dreamed he was playing an entirely new game 
of cards with three friends. When he awoke the structure and rules 
of the new game, as created in the dream, came, one by one, into his 
memory, and he found them so ingenious that he afterwards fre- 
quently played the game. 

Coleridge is said to have composed his fragment of "Kubla Khan" 
during sleep. He had one evening been reading Purcha's "Pilgrim;" 
some of the romantic incidents struck his fancy; he went to sleep, 
and his busy brain composed "Kubla Khan." When he awoke 
in the morning he wrote out what his mind had invented in sleep, 
until interrupted by a visitor with whom he conversed for an hour on 
business matters ; but, alas! he could never again recall the thread of 
of the story, and thus e ' Kubla Khan " remains a fragment. / 

Dr. Good mentions the case of a gentleman who in his sleep, com- 
posed an ode of six stanzas, and set it to music. Tartini, the cele- 



344 MEDICAL PRACTICE. 

hrated violinist, one night dreamed that the devil appeared to him, 
challenged him to a trial of skill on the fiddle, and played a piece 
wonderful for its beauty and difficulty. When Tartini awoke he 
coul 1 not remember the exact notes, but he could reproduce the gen- 
eral character of the music, which he did in a composition ever since 
known as the "Devil's Sonata." Lord Thurlow, when a youth at 
college, found himself one evening unable to finish a piece of Latin 
composition which he had undertaken. He went to bed full of the sub- 
ject, fell asleep, finished his Latin in his sleep, remembered it next 
morning, and was complimented on the felicitous form it, presented. 

Somnambulism. In sleep-walking we have a species of dreaming, 
with eyes open and the muscular system under control of the imagi- 
nation. "While some of the senses and mental faculties seem to be 
uncommonly acute, for often feats, dangerous in wakeful moments, 
are easi'y performed, other of the senses are peculiarly dull and 
blunt. The dreamer may Fee di tinctly, but it is next to impossible 
to make him hear. Nor is he sensible to touch although he may be 
shook severely and even handled roughly, without awakening. Indi- 
gestion and late and hearty suppi rs are some of the causes. While 
the digestion is being improved, the doors and windows should be 
fastened at night and all fragile articles of furniture removed from 
the room. 

Somnolency is sleep protracted beyond the regular periods. It is a 
symptom of some diseases. 

Coma. 

This is defined as a profound state of sleep from which it is ex- 
tremely difficult to rouse the individual. The eyes are closed and by 
calling loudly may be opened, but only momentarily. This condi- 
tion accompanies many diseases and we give it special notice only 
because we are shocked every little while by the newspaper reports 
that some one was picked up in the street and taken to a prison-cell 
where he died during the night. Can we tell whether he was drunk 



COMA. 345 

or dying? Not so easily, but if there is the least doubt, better send 
to a hospital : it will not injure the drunkard, and may save the life 
of the apopletic. To show the fears that pervade intelligent circles, 
a recent incident is in point. A patient was taken with vertigo. 
Thinking it would soon pass off he continued to walk, or rather 
stagger, hoping to reach a drug store. "When it was impossible to go 
any further he " embraced " a lamp post. Almost unconscious and 
speechless, he happened, on looking about for help, to find that he 
was watched by one of the "best police in the world." A news 
item in the morning's paper came to his thoughts and he declares his 
mental sufferings during the next ten minutes could not have been 
greater if he was about to be led to the gallows. 

First, smell the breath. The scent of liquor does- not necessarily 
imply drunkenness, as he may have take'n a small quantity because 
he felt unwell, or it may have been administered by a friend. Next, 
look for wounls on the head. If deep, they may have come from a 
blow, but if slight, possibly from the fall of a fit. From "stun- 
ning," recovery is slow or rapid, but. progressive. The feebler respi- 
ration, rapid but weak pulse, and nausea soon pass off. Not so, 
however, if the injury or disease has caused compression of the 
brain by internal bleeding (apoplexy), or by fractured bone. The ' 
insensibility is more complete, the respiration labored and noisy, 
pulse slow, eyes fixed, and pupils, bowels and bladder relaxed. 
Again, observe the tongue, and if bitten and b'eeding, it may be in- 
ferred that the attack was epileptic; from this, however, conscious- 
ness speedily relurns. Poisoning may be suspected; if from opium 
or morphine the pupils will be found closely contracted and the sur- 
face bathed in profuse perspiration. 

TREATMENT. 

As most of the conditions above alluded to receive special atten- 
tion in other places, only general directions are given at this time. 
As paralysis follows apoplexy, great care is necessary to diagnose it. 
Besides, a treatment that would meet most cases of coma would here 
be likely to increase the danger, if not destroy life. In apoplexy the 
15* 



346 MEDICAL PRACTICE. 

head must be raised and supported, the feet kept warm, the thighs 
bandaged to keep the blood in the veins of the legs and away from 
the head, and a cathartic given. The use of ammonia, amyl and 
emetics, are strictly prohibited. If it is not apoplexy the strong 
spirits of ammonia may be sprinkled on a handkerchief or cloth and 
brought near the nostrils. If the stomach contains alcohol or poison 
the stomach pump or emetics may be employed. If the skull is frac- 
tured and there are signs of compression, the surgeon's help is nec- 
essary to raise the depressed bone. "With returning consciousness 
from coma headache is discovered, necessitating quiet and rest. 

Progressive Locomotor Ataxia. 

The characteristic of this disease is the loss of control of motion, 
or the nerves of motion. The person cannot direct the muscles or 
control their action so as to effect his purpose. He may be unable 
to walk or stand without assistance and yet be able when seated to 
thrust out his f«et as vigorously as before his powers were impaired. 
The disease is often preceded for years by spinal irritation. Some- 
times pains, like galvanic shocks, pass down the legs and thighs. 
The disease progresses slowly for years. In walking the ground 
feels soft and shaky, the gait is uncertain and tottering, or there is 
inability to walk without assistance. The attention is strongly di- 
rected to the motion of the feet and when the eyes are closed the 
patient cannot stand and begins at once to fall. The limbs in walking 
are jerked spasmodically upward and forward and then brought 
forcibly to the ground. The feet rise unequally and the knees give 
way from before backward. The left side is usually more affected 
than the right. As the disease progresses, the upper limbs become 
involved and the patient cannot button his coat or take his food 
without assistance. 

Treatment. — No general directions can be given. 



SOFTENING OF THE BRAIN. 347 



Softening of the Brain. — Mollifies Cerebri. 

This is a disease in which the nerve cells of the brain become 
degenerated. Of the causes producing it we have sufficient 
knowledge, but of the process itself we know nothing. The signs 
of its existence are quite apparent, but the change in structure is so 
slight that it can only be detected by the microscope. We are not 
now considering mechanical softening caused by dropsy, hemor- 
rhage and apoplexy, nor putrefaction following death in warm 
weather. Softening occurs mainly in adult life and is rarely, though 
occasionally, seen in the young and midd'e-aged. In later years, 
and more particularly in cities, it is being more frequently developed 
in middle life. The disease being one of exhaustion and irritation 
of the brain, any overstrain telling upon the nervous system becomes 
an exciting cause. The inevitable sequences of the extra press of 
business, its unusual confinement, the rapid gain or loss of money, 
the sudden demise of loved ones, the consciousness of guilt, the in- 
volvement of estates and the excitement of venture, are anxiety and 
worry. Attendant upon these conditions and intensifying them are 
the ph} r sical phenomena of dyspepsia and sleeplessness. By what 
friends term "eccentricities," the profession discover that the brain is 
affected, but their timely warning of danger is little heeded. 

This is the age of steam, of electricity, of rapid intercommunica- 
tion. The measured cadence of the cutting saw is replaced by the 
buzz of the steam saw ; the once familiar sound of the ploughing 
plane is substituted by the hum of the planer ; the creak of the 
wooden weaver gives way to the rattle of its steel and iron rival ; the 
coach, slow and lumbering, is transformed into the railway carriage, 
thundering along at the rate of a mile a minute ; the newspaper is 
dissatisfying unless it supplies the records of yesterday's events in the 
whole world, to be digested with one's breakfast. We are proud 
of such achievements ; but we regret their cost and their influence. 
This high-pressure activity produces morbid excitement, unrest and 



348 MEDICAL PRACTICE. 

worn' in the people. When we were young we were all told that 
some day we might he President of the United States. Now the 
young and the middle-aged are goaded to ambition by examples of 
Stewart and Vanderbilt, that they may "amaze Broadway with 
haughty carnage." Public spirit is drowned in private greed. The 
health of the people is sacrificed without remorse in mammon wor- 
ship. Every department of life, social and political, is marked by 
immoderation and discontent. The demands of trade are never so 
great but the individual believes they can be met, and he flatters 
himself that he is capable if it should double. The artist, the author, 
the professional man, covet the fame of those who, 

' • While their companions slept, 

Were toiling upwards in the night." 

The lash so frequently applied must leave a scar. Retribution fol- 
lows. Under the overstrain the nervous system yields. 

Intemperance and insanity will often develop softening of the 
brain. The old sot stops his career in imbecility and breaking down 
of the nervous system. In children whose brains grow too fast 
and bodies too slowly, it appears, or may arise from a constitutional 
tendency in this direction inherited from the parents. The hard 
brain worker, like the inventor, or lawyer, or editor, or clergyman, 
or broker, or speculator, is a common victim. 

The symptoms vary according to the part of the brain affected, 
whether the disease is of rapid or tardy development. Acute at- 
tacks may be associ ited with delirium. In all cases there is head- 
ache, feebleness of intellect, depression of the muscular and physical 
powers; palsy, temporary or permanent; and loss of memory to such 
an extent that tliey forget what they have done or if they have eaten, 
and will repent either if opportunity offers. Even words are recalled 
with difficulty, and sometimes there is constant babbling of the same 
words or sentence. Like the insane, some have a favorite subject 
upon which they can converse without difficulty, but are obtuse in 
all others, recollecting with great difficulty, if at all, the names of in- 



SOFTENING OF THE BRAIN. 849 

timate friends and places and the circumstances of remarkable times 
and events. Occasionally we meet with muttering, foolishness, 
silly incoherency, stupid vacuity ; even lethargy, trembling, tendency 
to coma and paralytic fits and convulsions. 

TREATMENT. 

This is chiefly prophylactic and consists in avoiding excitement or 
other cause. Examination of the urine discloses the fact that the 
phosphorus of the system is lost in large quantities; hence the ad- 
mixture of this agent is forcibly indicated. Give therefore a pill 
consisting of 

1$. — Phosphorus, . * , *. . one hundredth of a grain. 
Nux Vomica, . ... . one -quarter of a grain. 
* Mix. 

One immediately after each meal. Or if the person cannot swal- 
low pills, give 

IJ. — Dilute Phosphoric acid, .... one ounce, 

Simple Syrup, five ounces. 

Mix. 
Teaspoonful every four hours. Counter-irritation by mustard 
paste to the buck of the neck, or by bathing the spine with tincture 
capsicum; by sprinkling cayenne pepper through a sieve upon that 
side of the sole of the stocking which comes next to the foot: these 
plans call away the blood from the head and are to this extent 
remedial. In anaemia or bloodlessness, give citrate of iron or some 
other preparation of this metal. If there is a tendency to convul- 
sions, give the bromide of potash compound, presented in the treat- 
ment of epilepsy. (See pige 361). 

The amount of food should be restricted to a little less than that 
required by a healthy adult of the same au r e and constitution. If 
dyspepsia is present, it should be managed as indicated in the essay 
upon tli is topic. Electricity is of advantage in improving the mus- 
cular powers. Constant quiet is impera'ive and, in addition to good 
nursing, can be best secured by change of locality. Moderate out- 



350 MEDICAL PRACTICE. 

door exercise or systematic gymnastics under a physician's supervi- 
sion is beneficial. In confirmed cases there is no remedy; the mind 
is shattered and the brain disorganized. 



MENTAL DERANGEMENT. 



Insanity. 

In some form all have duties and cares incumbent upon them. To 
the facility with which these are performed or discharged, is due 
much of the confort and pleasure of life. But the extra press of 
business, its unusual confinement, the rapid gain or loss of money, 
the demise of loved ones, the consciousness of guilt, the involvement 
of estates, the excitement of venture, all beget anxiety and worry. 
Attendant upon these conditions and intensifying them are the physi- 
cal phenomena; loss of appetite, constipation and sleeplessness. By 
what friends may term "eccentricities," it is discoverered that Ihe brain 
is affected, and the professional warning of danger is little heeded. 

"During the early stages of dementia induced by mental anxiety," 
Dr. Richardson slates, "there is nothing more than an increased ten- 
sion of the minute vessels which supply the brain. In later stages 
the substance of the nervous tissue itself undergoes a modification 
by which its activity is permanently lost. These are the physiologi- 
cal consequences most briefly summed np. The first symptom is a 
want of full bodily vigor, then follows craving for more work, dis- 
turbed sleep, acute sensitiveness to external impressions and finally 
strange figures and sounds are seen and heard. This condition may 
continue for years and the sufferer may in time begin to accept ab- 
normal creations as natural." Dr. Richard- on cites a ca c e of a mer- 
chant who for weeks retained in his vision the spectre of three lights, 
oval in shape, of the size of an egg and so clearly defined to the ob- 



INSANITY. 351 

server that he would watch them half consciously as they float' d 
before him on the wall, the ceiling or in space. In this stage of the 
disease lies the foundation of all hypotheses of ghost seeing, of 
ecstatic visions and even of poetic frenzy. 

"It is a well-known fact that we have two nature^, one pur: ]y or- 
ganic and emotional, the other subject to the reasoning powers. The 
organic nervous chain exists in the body as a link between emotional 
mental acts and vascular supply. An impression from without, » ; 
made through the organs of the senses, upon the emotional centres, 
is reflected directly upon them to the vascular expanse. The part 
flushes or blanches and the heart hesitates, palpitates, rebounds or in- 
termits; so that these centres, excited by anxiety, or grief, or joy, or 
sorrow, influence the waves of blood passing through the system and 
the brain promptly feels the imperfect regulation of the supply. 
Under varying tensions of the vessels, there are flushes, chills, cold- 
ness of the extremities and other oppressive symptoms, while in ad- 
dition appear the distressing ringing or hammering sounds in the 
head. These sounds are arterial murmurs or vibrations of the blood, 
which press, with each impulse of the heart on the bony surround- 
ings of the relaxed carotid canal, situated at the base of the skull. 
The cause is in direct connection by solid conducting substance with 
the organs of hearing and thus the faintest vibration is detected. 
The sound produced when it is sudden and expected, as in moments 
of fear, is occasionally mistaken for a sound from without, with no 
obvious cause. These are to the sufferer as purely physical as the 
common things of life, but 'in the majority of instances they are 
actual impressions mr.de at some time on the organism and now re- 
called and rendered more definite by a constant reeurrenc e. 

At Ibis point if the mental powers be allowed rest and the foun- 
tains of care be closed recovery may take place; but if the over-strain 
continues, the disease assumes a still graver form. There is a mad- 
dening desire for work, more work, coupled with the sad sensation 
that the physical powers are failing; and then there are lapses 
of memory. The man of business forgets important details, he is ir- 



352 MEDICAL PRACTICE. 

ritable, distrusts everybody and himself most, makes mistakes and 
yet persists in accumulating more work on himself. The poet and 
moralist become over-sentimental and morbid ; the man troubled with 
remorse for guilt confesses his crime or commits suicide. The down- 
ward course is rapid ; in one case epilepsy occurs, in another, par- 
alysis, a third develops some hereditary malady like cancer, a fourth 
dies from nervous failure and local disease of some vital organ. 
The majority, escaping these special ends, become prematurely old 
and sink helplessly into death. The brain becomes disorganized, 
the balance is broken and anarchy succeeds to what once was order." 
Next to worry and anxiety in the chain of causes comes excessive 

Brain Work. 

It is a common thing in the present age for men to exert their 
brain at the expense of their body, giving undue labor to the one, 
aLd scarcely giving enough to the other. Health of mind and health ' 
of body ought to go togeth< r, and if a man wishes to make the most 
of himself and of his faculties, he should observe r< gular hours for 
si ep, work, recreation and exercise, and be temperate in his diet and 
in all other things. He should treat each day of his life as a whole 
in itself, and avoid bringing himself into a state in which artificial 
stimulants become a necessity. But how many persons do we find 
following these simple and oft-repeated rules? As a rule, profes- 
sional men permit themselves to be overtasked, for they dislike reject- 
ing business w T hen it offers itself. And the same may be said of mi n 
engaged in trade and commercial pursuits. While business is brisk 
they will do, or attempt to do, all that is possible, without regard to 
t c pernicious strain upon their system which such overwork entails. 
If to this be added the perpetual anxiety, hurry, loss of temper, dis- 
couragement at losses or failure and undue exultation at success 
which characterize the life of most business men, together with the 
system of taking hasty meals and not allowing sufficient time for 
sleep and relaxation, one need not be surprised at the number of pre- 



BRAIN-WORK. 353 

mature deaths which daily occur. The wonder is that it is not greater. 
When a man desires to do a very great quantity of work he almost 
always is obliged to violate the rules of health to accomplish it; he 
has to pay a price- for being allowed to do it; unless gifted with a pe- 
culiarly strong organization, his labor is accompanied by its own 
retribution. Of course, there frequently occur situations when men 
must work to the utmost; they have no choice; but on the whole, it 
may be affirmed that most of the ordinary work of the world may 
be got through without any glaring inattention to, or defiance of, the 
rules of health and the requirements of society. And if each man 
would try to find out how he can best do his own work and not try 
to do it according to the ways of others, a great deal of useless toil 
and irritation might be saved. 

It may, perhaps, be urged, that there have been many brilliant cases 
wherein the rules of health were not only violated but outraged, and 
yet the work performed was of the very highest order. This is un- 
doubtedly true of many men of extraordinary genius, who were, 
however, exceptional men in every sense of the word, and hence 
their example is not to be cited as that which ordinary persons should 
follow. No one, for instance, should do as the great French novel- 
ist, Balzac, used to. When he was engaged on a novel he would re- 
tire wholly i'rorn the world to write with scarcely any interruption 
and without taking any exercise from two o'clock in the morning till 
six in the evening; he allowed himself six hours sleep, and lived 
entirely on fruits and vegetables. At the end of some months of this 
life he would enter the world again looking like a spectre; yet it may 
be true that it was only by such abnormal work as this he could 
achieve what he undertook. The vast majority of men would break 
down under it; some men cannot do bra in- work well except at night. 
This was the case with Schiller; while his great rival, Goethe, did all 
his work in the morning and never wrote after his mid-day dinner. 
Sir Walter Scott wrote his novels mainly before breakfast, while 
Byron composed his poems mostly late at night. The contrast be- 
tween the results of these two opposite systems of labor is remark- 



354 MEDICAL PRACTICE. 

able in these four cases. Goethe and Scott respectively attained the 
agest>f eighty-four and sixty-one, while Schiller died at forty-six 
and Byron at thirty-six. Moreover, Schiller indulged in champagne, 
and Byron in gin and water, and both habitualy wrote under the 
influence of stimulants. They shortened their lives by their irregu- 
lar mode of living and working. Goethe worked without stimulants, 
and Scott, though not averse to wine and ale, was a temperate man, 
an early riser, and fond of field sports and exercise in the open air. 
But even he ultimately succumbed to overtensi n of the brain in his 
desperate but honorable efforts to pay off the debts for which he consid- 
ered himself responsible. Had it not been for this unnatural brain-work 
he might have lived many years longer. Southey, though a diligent 
student and constant worker, would never, under any circumstauces. 
do with less than nine hours' sleep, and he was an abstemious man; 
accordingly, he lived to the age of sixty-eight. He did all his writ- 
ing by day. The late Archbishop Whateley, who lived till nearly 
eighty, was, however, a remarkable instance to the contrary. He 
said that he could not produce original matter except at night, but 
that he could best criticise and correct in the morning. The habit of 
writing and reading at night may be acquired and, indeed, it very often 
is, especially by persons connected with the press and by others who 
are called upon by their avocations to do brain- work in the evening, 
such as actors, lecturers, preachers and others. Nevertheless there 
is good reason to believe that all of these would accomplish more by 
working as much by day as their avocations will permit, and not un- 
dertaking too much. (Phila. Ledger.) 

The Hon. W. W. Phelps, addres.-ing an Alumni Association, made 
the following excellent remarks : " Written by God on the face of 
creation is the law of rest, a law that we all break. The law is 
broken constantly, recklessly, and with fearful consequences, by 
our American people. You medical men know the fact, you 
meet it at every point in your professional circle. Why don't 
you proclaim the danger ? Organize a missionary society, preach 
everywhere the new gospel. It will be an earnest, fighting mission. 



BRAIN-WORK. 355 

The traditions and habits of an hundred years are against you ; the 
teachings of the good and the bad unite to defeat your efforts. Amer- 
ican art and literature are against you, and so are our natural re- 
sources and free institutions. The atmosphere, social and political, in 
which we move and have our being is against any effort that would sub- 
stitute moderation and contentment, rest, for a restless activity. Work 
— the duty of the work he must do — is the cradle-song of the American 
babe ; work — the glory of the work he has done — is the funeral 
eulogy of the American man. Work, says the devil, and you will 
gain the world. Work, says the saint, and you will gain heaven. 
Work, say our literature and legends, and our school-rooms tell the 
glory of those who, 

" While their companions slept, 
Were toiling upward in the night.' 1 

Nor is art behind, but feeds the flame with moving pictures of heroic, 
supreme effort. One sovereign State chooses for its insignia " Excel- 
sior;" another, " Sic itur ad astra" And under them all, the tyrant 
of the nineteenth century, Public Opinion, comes in to contemn all 
idleness, to honor all work. All these voices whisper to the soul and 
fill it with dissatisfaction and unrest. It needs only Hope to rouse 
it to action. And Hope comes, and points with a sunbeam to 
national resources that were never equalled, and a highroad never 
before opened to all. And while she points, the air echoes with the 
shouts of those who triumph. The prizes are brilliant and numerous. 
Each shout of triumph stirs the sluggard and crazes the aspiring. 
Everything is, to the American who wills. Vanderbilt, who ped- 
dled cabbages in a scow, dies worth one hundred millions. And 
on Sunday the metropolis lowered its flags for Benjamin F. Wade, 
thrice Senator from Ohio, once navvy on the Erie canal. 

And what are the consequences of this contempt of rest ? We are 
a nation without contentment, without ret, without happiness. 
In a feverish race we pass from the cradle to the grave, successful 
men to whom life is a failure. Our boys leave the university when 



356 MEDICAL PRACTICE. 



I 



English boys leave their school. Our merchants leave their trade, 
retiring to some more dignified or honorable work, as they believe it, 
at an age when the German merchant fee's himself the master of his 
trade. We are always anticipating the future, forcing the task of a 
whole life into part. Worse, we are not content with doing a year's 
work in a month in our own calling, but we must do enough in all 
other callings to win distinction there. In other lands it is enough 
to be a lawyer, physician, clergyman, merchant. Here we are no- 
bodies unless we fill the sphere of all human occupations. He must 
be a statesman, and know political science, as if already in office. He 
must be an orator, and ready to persuade and instruct : a wit, to 
shine at the dinner-table ; a litterateur, a critic. There is too much 
human nature in man for this to mean anything except, a discontented 
life and a premature death. And the remedy ? 

Correct public opinion. We must hnnor the man who faithfully 
does his task, whatever it be. Not the task, but the faithfulness with 
which it is done, mu4 be the measure of the honor. Then men will 
be content with their father's house or their father's trade. This 
will give us that family association which is a sure pledge of good 
conduct and patriotic love. This will give us too that traditional 
aptitude which alone gives great mechanical excellence. It will not 
be a bad time for American manufactures when we find stamped on 
them what Mr. Griffis finds on Japanese bronzes, "Done by the 
ninth bronzer in this family.'' Then men will keep the occupation 
of their youth for their age, and having leisure, will build the foun- 
dations broad enough to withstand bankruptcy. Then men will 
seek excellence in their calling and not compete with the excellent 
in other callings. Then men will alternate labor with rest, and 
obey the law which God has written on creation ; God, who him- 
self rested after toil ; God, who shrouds the earth with the night, 
that it may take its daily sleep; God, who speak< st to the tor- 
rent to stop at once amid its maddest plunge. Shall our coun- 
trymen— the men whom we know and love— alone defy this law? 
Shall they selfishly destroy a life which belongs to their families 



INSANITY. 357 

and to us ? Let us practice and preach that moderation even in 
good courses, which is the only wisdom." 

Inebriety is another cause of insanity. Alcohol flies to the brain, 
and not unfrequently dethrones reason and leaves its victim an help- 
less idiot or a raving maniac. Drinking parents beget imbecile or 
insane children. Dr. Howe of Boston tells us that out of 300 in- 
mates of an asylum there, he knew that 147 had drunken parents. 
In addition to deranging the mental faculties of otherwise perfectly 
sane persons, drinking develops tendencies to insanity that already 
exist. As there are grades in insanity, so there are grades between 
perfect mental soundness and insanity. Every one knows people 
who are "eccentric," '"flighty," or "weak-minded." Alcoholic 
liquors readily affect such, and numbers of the inmates of our 
asylums are people of this class who have had the tottering 
balance of their reason completely upset by drinking. Many are 
driven mad by anxiety on account of losses and deaths caused 
by intemperance. 

Insanity may result from excessive joy, grief, jealousy, home- 
sickness, anger, religious excitement or delusions, dread of the fu- 
ture, fear of friends, of being poisoned, of losing wealth; from mastur- 
bation, excessive venery, sexual diseases ; from epilepsy, softening 
of the brain, etc. The range of aberration is extensive. Mania is 
explosive, and the tendency is to raving, fury and madness. If the 
unsoundness is upon one subject only, it is termed Monomania, but 
there is not that degree of irritability and frenzy. The patient is gen- 
erally melancholy, timid, sad, gloomy and unsociable, and only be- 
comes excited or shows mental derangement in one direction. The 
alcohol disease {Dipsomania) is of this class ; so is Kleptomania, an 
irresistible propensity to steal, and Hypoclwndriasis, a settled but 
erroneous belief that a mortal disease is slowly destroying the person. 
Dementia is a condition without mind, varying from imbecility to 
total loss of power of reasoning. Idiocy is confirmed dementia, with 
a complete obliteration of the powers of intellection. Many are born 



358 MEDICAL PRACTICE. 

in this condition ; in others it may develop from other forms of in- 
sanity or from diseases of the brain, as softening. 

Generally the aberrations are slight at first, the person courts sol- 
itude, and is easily provoked or displeased when disturbed. The 
mental derangement may be suspected by peculiar expressions, ac- 
tions or inclinations, by restlessness, sleeplessness, and by unnatural 
impulse. 

TREATMENT. 

It is impossible to come to any other opinion than that insanity is, 
to a large extent, a preventible malady ; and it appears to us that it is 
in the direction of preventing its occurrence, and not in the creation 
of institutions for its treatment, that any sensible diminution can be 
effected in its amount. Lunacy is always attended with some bodily 
defect or disorder, of which it may be regarded as one of the expres- 
sions or symptoms. We must, therefore, attempt to prevent its oc- 
currence in the same way as we attempt to prevent the occurrence of 
what are called ordinary bodily diseases ; and if it be admitted that, 
to a large extent, preventable diseases exist among us in consequence 
of the ignorance of the people, it is clear that we can only convert 
the preventable into the prevented by the removal of that ignorance 
by a sounder education. To this, and not to any machinery, how- 
ever good it may be for the treatment and cure of the insanity which 
has actually arisen, can we reasonably look for its diminution. 

Dr. Choate observes on the same topic : "The more we see of 
mental disease in its various forms, the more we are convinced that 
the study of its prevention is infinitely more important than even the 
study of its cure, and that the dissemination of more correct views 
of the true way of living, and a more rigid observance of the laws of 
heal ih and nature, would greatly diminish its frequency." 

The majority can be cured if taken in time. The chances of re- 
covery lessen with the duration of the disease and the approach of 
old age. It varies with the cause ; those cases originating in organic 
disease yielding the more readily to hygienic and medical treatment. 



EPILEPSY. 359 

Falling Sickness, Fits.— I 



This is a disease of the nervous system and from the suddenness 
of the seizure, which fells the patient to the ground in convulsions, 
it has been termed falling sickness. Post-mortem examinations have 
thrown no light upon the conditions producing the attacks. Each 
organ has, in turn, been found affected and sometimes, strange to 
say, all parts of the body are discovered healthy. Cases are met 
with in which it is hereditary ; in others, the causes of irritation are 
apparent; in some it arises from nervous debility ; in others it is sponta- 
neous or accidental. There is a sudden and complete loss of sensa- 
tion and the patient falls to the ground ; the head is turned to one 
side, the eyes upturned, the tongue protruded, and the face purplish 
and livid. The teeth grind and gnash and the tongue is frequently 
bitten, the blood mixing with the foam which collects at the mouth. 
The breathing is labored and hoarse, at limes suspended with violent 
spasms of the limbs. This is the description of a severe but ordinary 
attack. Gradually the spasms abate and stupor or deep sleep fol- 
lows. In from five minutes to a half hour consciousness is recov- 
ered. The person has no knowledge of what has transpired during 
the interim. Headache and exhaustion follow, but when these dis- 
appear the person seems as strong as ever. The attacks vary in de- 
gree. If slight, the person may fall, the jaws set, the eyes become 
fixed, the fists clinch, and with a few tremors of the frame, recovery 
take place. Some do not fall but are only momentarily unconscious. 
From such as this to the epilepsy ushered in by a piercing scream, 
accompanied by severe convulsions, involuntary dejections, and fol- 
lowed by days of furious mania, we have the various shades in which 
it is presented. 

An interval of exemption follows the fit, but of uncertain duration. 
As the disease becomes more firmly seated, the system at the same 
time becoming more debilitated, usually the interval diminishes and 
the severity of the paroxysm increases. The disease may gradually 
pass away or result in idiocy. 



860 MEDICAL PRACTICE. 

Fits, like fainting, are " catching." We remember when a school- 
boy, a lad on our bench fell in a fit, his neighbor soon followed and 
a third. Our time was coming. But the principal boisterously de- 
clared he would flog severely the next boy guilty of such M foolish- 
ness," and bringing down his rule with great vehemence upon his 
desk, reassured us. This ended the scene, but we fancy that there wa3 
many a countenance 

"Sicklied o'er with the pale cast of fear." 

A paroxysm may be sudden and without premonitory symptoms; 
or there may be days or hours of headache, lassitude, irritability and 
depression, mental and physical. Sometimes there is a peculiar 
creeping sensation arising from the 1 mbs to the head, which is called 
in medical parlance, aura epileptica. 

Remarkable as it may seem, this disease is feigned. Hysterical epi- 
lepsy is more common than would be supposed. The principal ob- 
ject is to elicit sympathy. Once we were called to a church to save a 
young man " dying in convulsions." Studying the ca?e a few mo- 
ments we detected the fraud. The congregation was dismissed, the 
lights extinguished but one, and tapping the young man upon the 
shoulder we told him to " get up and put on his coat and hat as we 
wanted to lock up the building," and Tie did so. Our prescription 
should have been: I£. — Horsewhip. 

TREATMENT. 

As a precautionary measure persons once experiencing an attack 
should studiously avoid elevated positions, such as scaffolds, ladders, 
the edges of roofs, boats, piers and precipices, proximity to fires, un- 
less screened, and even stairways. Sometimes the first favorable 
report we receive is that the party feels confidence in going down stairs. 
The object of these precautions is evident. A wedge to which a 
string is tied made of leather, rubber, cork or wood, must be placed 
between the teeth to prevent mutilation of the tongue. The parox- 
ysm may be treated the same as a convulsion, (see Convulsions.) or if 
nothing else can be done the patient should be restrained from injur- 



FALLING SICKNESS. 361 

ing himself. Methods of cure can only be effected between parox- 
ysms. All causes of irritation must be removed. Among these may 
be mentioned rheumatism, gout, syphilis, scrofula, excess or perver- 
sion of organic cbange at puberty, pregnancy or dentition, tobacco, 
worms, sunstroke, overwork, emotional disturbances, excessive sexual 
communication and masturbation. The latter is a fruitful source of 
epilepsy. The remedial means will depend much upon the condition 
of the blood-vessels of the brain. The opthalmoscope will decide 
the matter. If the arteries are congested use the Extract of Bella- 
donna in one-fourth grain pills, every three or four hours at expected 
time of attack; at other times in one-eighth grain pills. If con- 
tracted, 

1^.— Bromide of Potash, .... one ounce, 
Bromide of Ammonia, . . . one ounce, 

Water, eight ounces. 

Mix. 

Dose, a teaspoonf ul three times a day. Tonics are also necessary. 
Dr. C. E. Brown-Sequard, the eminent physiologist, prescribes 
$.— Iodide of Potash, . . . two drams, 



Bromide of Potash, 
Bromide of Ammonium, 
Bicarbonate of Potash, 
Infusion of Colombo, 



two ounces, 

two and a half drams, 

two scruples, 

six ounces. 

Mix. 

Dose, a teaspoonful before each meal and three at bedtime. When 
the patient's pulse is weak, substitute in above for bicarbonate of 
potash, sesqui-carbonate of ammonia, and for the six ounces of infu- 
sion of Colombo, one and one-half ounces of tincture of Colombo, 
and four and a half ounces of distilled water. 

Hystebia. 

This is a nervous affection, remarkable for the numerous forms it 
assumes and the number of serious maladies it simulates. There is 
16 



362 MEDICAL PRACTICE. 

a diseased condition of the mind as well as of the nervous system, a 
greater susceptibility to emotions and an inability of the will to con- 
trol them. In a very large proportion of cases, hysteria has been 
found to accompany organic disease of the uterus, ovaries, uterine 
irritation from functional disturbance, displacements of the uterus, 
leucorrhcea, etc. An attack is usually caused by mental anxiety cr 
excitement, grief, disappointments in love, fits of anger, jealousy, 
etc. The nervous temperament, the precociously developed, and 
those brought up amid the excitements and luxuries of city life 
are most susceptible. The attack is sometimes preceded with fits of 
yawning, sighing and irrepressible laughter. Globus Hystericus is 
the name given to the most common form. There is difficult breath- 
ing and a choking sensation as if a solid ball were ascending from 
the abdomen to the throat, weeping, laughing, vomiting and palpita- 
tion of the heart. This generally passes off with sobbing, copious 
discharges of urine, followed by great depression of spirits. When 
the attack is severe, we may have some one or more of the following 
difficulties : Headache, gas in the intestines, with pain and bloating, 
obstinate vomiting, lancing pains in the chest as in pleurisy, neural- 
gia, rheumatism in joints, paralysis of motion or sense, convulsions 
of the eyes, limbs or whole body, delirium or coma. 

It is to be distinguished from most diseases which it mny in its 
course resemble by the previous symptoms of weeping, laughing and 
the "ball" in the throat. A test in cases where pain, soreness, 
swelling, etc., are complained of, is, that firm pressure can be made 
without causing pain if the attention of the patient be diverted for* 
a moment; when the thoughts are upon the part a feather has un- 
bearable weight. In pleurisy a full inspiration is avoided, in hys- 
teria the chest is expanded freely. In hysteria the respiration is 
natural, the pu'se regular, the pupils respond to light and the patient 
is seldom totally unconscious. These symptoms are exactly oppo- 
site in the coma of apoplexy. In epilepsy or falling sickness there 
is no stricture in the throat, in hysteria, no foaming at the mouth; 
epil psy is sudden and involuntary, hysteria comes on gradually and 



HYSTERIA. 363 

the spasms are partly under control ; in the former the patients in- 
jure themselves, bite the tongue, etc., in the latter seldom injure 
themselves. 

It must be remembered that hysteria and organic diseases may ex- 
ist at the same time. If so, the previous history will disclose the 
fact. 

The indications are to stop the attack, remove uterine diseases, if 
any, and tone up the nervous system. 

TREATMENT. 

Opium, alcoholic stimulants, blisters, and all strong medicines are 
to be avoided, for all cases, if left to themselves, recover ; even hys- 
terical coma and convulsions terminate favorably. Perfect quiet is 
imperative. Most cases of " globus " hysteria recover in a few minutes 
by pouring cold water from a pitcher or spout upon the thigh, abdo- 
men or head. Pouring upon the head is good treatment in all the 
forms of this disease, even in coma. After the paroxysm is over- 
come the nervous system can be effectively quieted by the follow- 
ing : 

fy— Fluid Extract of Valerian, 

Fluid Extract yellow Lady-slipper, 
Aromatic Spirits of Ammonia, . equal parts of each, 

Mix. 

Take a teaspoonful in a little cold water every fifteen or thirty min- 
utes until relieved, then every hour or two. The cause, whether 
uterine disease or not, should then be sought for, and as far as prac- 
ticable, removed. 

Catalepsy is called a fit because it occurs in paroxysms. It is a 
kind of hysteria, and like it, greatly dependent upon uterine disease. 
There is complete and sudden suspension of consciousness and of 
volition. The rigidity of the muscles during an attack is remarkable; 
the body and limbs retain any position that ma)'' be given them, no 
matter how apparently uncomfortable or painful. 

Trance is long continued insensibility. Sometimes the person will 
swallow food put into the moutb, at other times will not. Some 



364 MEDICAL PRACTICE. 

open the eyes and see and know all that is going on about them, al- 
though they cannot move or speak. . Others may be unable to do 
even this, and yet sense sounds. Both these and the cataleptic are 
liable to be buried alive. In either case the treatment consists in 
tending to the wants of the nervous system, and are managed in 
about the same way as hysteria. 

Saint Virus's Dance.— CJiorea. 

This is a disease of the nervous system occurring in the young and 
manifests itself at first by involuntar}^ twitchings of the muscles of 
the face or arms. Usually other muscles soon become involved and 
it may involve one-half or the whole body. The contractions may 
twist the body into a variety of attitudes, throwing the arm forward 
or backward, turning the hand over and suddenly reversing it. The 
legs may be twisted in, or everted, or thrown suddenly across each 
other; and even in attempting to walk, the intended slow movement 
may become a rush and a jump. The face may be contorted and 
mouth twisted. The patient is anno}'ed by the condition and shrinks 
from observation. They often cease entirely during sleep. It occurs 
most frequently in girls and between the ages of eight and eighteen. 

Tlia indications are to relieve all irritations, such as wounds, stom- 
ach affections and worms in the bowels, bloodlessness, and the want 
of tone in the nervous system. 

TREATMENT. 

The cause, if discoverable, must be removed. If worms, they 
must be expelled. If anaemia or bloodlessness, a cathartic followed 
by stimulating tonics and iron will go far towards effecting a cure. 
A remedy that will meet the majority of cases is a tea or syrup made 
from the yellow Lady -slipper. 

Lockjaw.— Tetanus. 

This disease results from a wound. This injury seems to spend its 
greater force upon the lacerated nerve or nerves and through this 



LOCKJAW. 365 

system the whole frame becomes involved. The appearances, how- 
ever, being confined chiefly to the muscles which are contracted and 
rigid, would indicate that they alone are affected. The magnitude 
of the injury is in no proportion to the severity of this malady. A 
blow which will affect the flesh to a considerable extent may occasion 
, it, and it has been known to develop from so slight a cause as prick- 
ing the finger with a tack. In horses it is frequently developed by a 
nail puncturing the foot. From a sense of soreness about the wound 
there quickly follows a, stiffness of the contiguous muscles. This 
rigidity progresses towards the head, including all the muscular 
structure in its advance. Soon the neck and face are involved, and 
although consciousness is retained to the last, the countenance has 
a ghastly appearance. The jaws in turn are locked fast, swallowing 
is impossible, the pain extreme and the whole body rigid. 

Tlic indications are principally to overcome the tension or rigidity 
and allay the intense irritation of the nerves at the seat of injury; 
secondarily to heal the wound if extensive. 

TREATMENT. 

If means are employed before the neck and jaw are involved, the 
chances of success are much more favorable. The patient should 
be put to bed and the spirit vapor bath administered. Internally 
should be given the tincture gelseminum in ten-drop doses at inter- 
vals varying from a half hour to two hours, until complete relaxation 
ensues. About the injury and including much of the surrounding 
part, should be applied a slippery-elm poultice which is thoroughly 
saturated with equal parts of laudanum and tincture aconite root. 
This allays pain and irritation; the opium acting as an anodyne and 
the aconite as a benumber. This treatment should be continued for 
several days. It must be remembered that the aconite is a poison, 
and if the surface is much lacerated a strong solution of carbolic acid 
may be applied by a compress covered with tin-foil or oil-silk and a 
bandage. The poultice just alluded to may then be used as advised. 

If the jaws are locked at the time of beginning treatment and the 



366 MEDICAL PRACTICE. 

patient can swallow, tinctures lobelia and capsicum combined with 
a little water may be poured into the mouth between the cheek and 
the teeth. It will find its way into the stomach. Do es of this mix- 
ture should be repeated until free vomiting and relaxation. If swal- 
lowing is impossible the lobelia compound should be passed into the 
rectum. Tiie room should be kept dark and all noise in and about 
the house avoided. In cities a layer of bark should be laid in the 
street. All draughts of cold air must be excluded. The touch of a 
cold hand may provoke a spasm. Food can be given in fluid form, 
but must be warm. A general opinion prevails that cases of this 
nature are incurable, but we feel confident that by the treatment 
here recommended a majority may be successfully relieved. 

Convulsions — Clonic Spasms. 

By this term we understand " alternate contractions and relaxa- 
tions, violent and involuntary, of muscles, which habitually con- 
tract only under the influence of the will." They occur at any age, 
but more frequently in children. A supersensitiveness of the nerv- 
ous system in the young and debility in the adult, predisposes to 
attack. It can hardly be considered a disease of itself, but is rather 
a symptom of disease. Some point or points become the seat of 
irritation, which is reflected back to the spinal cord or brain when 
spasm or tetanus proceeds. Tremor is of this nature, but light; lock- 
jaw is a permanent spasm. Most people are aware of the danger of 
death to horses from lock-jaw when a nail has entered the foot. 
The irritatkm beginning in the foot culminates in the brain. So in 
the subject under consideration. Particular attention is directed to 
this matter in order that in every case of convulsions, the cause may 
be ferreted out and removed. This is not always practicable, as 
when the blood is poisoned with malaria and a child is taken with 
convulsions at the inception of a fever. But when arising from the 
presence of worms, indigestible food, retention of urine, surface 
irritation, teething etc., attempts to avoid the convulsions are almost 
fruitless, unless the local dift^culiy is abated. 



CONVULSIONS. 367 

Convulsions accompany some of the diseases of adult life, such as 
chorea, or St. Vitus's Dance, epilepsy, Blight's disease of the kid- 
neys, hydrophobia, hysteria, and the parturient state. "We treat of 
these under their proper headings. 

The premonitory symptoms of infantile convulsions are sometimes 
called inward fits. They demonstrate the presence of irritation. 
There are twitching of the arms or legs, drawing down the corners 
of the lips, the half-opened eyelids, upturned eyes, grinding of the 
teeth, and sudden starts. The convulsion comes suddenly, with un- 
consciousness, agitation of the limbs, flushed or purplish face, fixed 
or rolling eyes, and the head thrown back. 

TREATMENT. 

We have been in the habit for } T ears of administering by the mouth, 
or between the teeth, if the lips are set, one-half a teaspoonful of 
1$. — Chloroform, .... one dram, 
Compound Spirits of Lavender, . one ounce. 

Mix. 
And with the happiest results. Perhaps the use of chloroform by 
inhalation may be as good. A half -teaspoonful is poured upon a 
folded napkin or cloth, and held about one inch from the nose, al- 
lowing the admission of fresh air with the vapor of the anaesthetic. 
Infants are placed in a warm bath and cold packs placed upon the 
head, if the head is hot. It is a good plan to remove the clothing, or, 
at least, all constricting bands. Lobelia is a remedy that will meet 
all ages. When the convulsion is over, seek out and remove the 
cause. 

Nine-day Fits. — Trismus Nascentium. 

These occur in children under two weeks of age, as the name im- 
plies. The cause can always be traced to irritation of the cord. 
This may arise from rubbing or from wet or filthy dressings to the 
umbilicus or navel. 

TREATMENT. 

Apply to the spine a small strip of cotton wet in chloroform. This 



368 MEDICAL PRACTICE. 

stops the spasms, and when the smarting from the chloroform ceases, 
the child will sleep. Cleanse the cord and parts surrounding with 
soap and water, see that the clothes are dry, and spread on an old 
piece of linen some antiseptic ointment, and secure it with adhesive 
strips. This should be removed and new applied as often as it be- 
comes wet. If the diet is bad, take steps to furnish one more whole- 
some. 

Palsy— Paralysis. 

Palsy is the partial or complete loss of voluntary motion, with or 
without that of sensation, in any part of the body. It may be local, 
as in dropped wrist from lead poisoning, or excessive sweeping, or 
hand gardening, by those unaccustomed to such work. Another il- 
lustration of local paralysis is BelVs Palsy, in which one half of the 
face is motionless and atrophied, the other half being plump and ex- 
pressing the emotions naturally. A common form of paralysis is 
when one-half of the body is involved ; if it is the upper or lower 
half it is termed Paraplegia, if either side, Hemiplegia. A disease 
of the nerves shown in constant tremor is called palsy, shaking palsy, 
trembling jyalsy. Iremor is a more proper name. It is observed in 
the infirm, debilitated and aged ; also, in hard drinkers, those using 
narcotics, and workers in particular minerals. The hysterical are 
subject to a temporary but incomplete paralysis. It comes suddenly, 
with some powerful emotion, and the motions of the muscles of the 
face and of the tongue are unimpaired. In walking, when the palsy 
is pretty complete, the leg is drawn along as if lifeless, sweeping the 
ground. It is not swung round, describing the arc of a circle, as 
in ordinary hemiplegia. 

Palsy accompanies diseases of the brain, pressure upon its sub- 
stance, affections of the nerves, muscles and poisons chiefly mineral. 
It occurs more frequently in the apoplectic and epileptic, and, like 
these maladies, is likely to recur. The paralytic stroke is sudden but 
not always so: palsy following compression by tumors or in soften- 
ing of the brain is gradual and progressive. The premonitory symp- 



PARALYSIS. 869 

toms when present are flushed face, swelled veins of the head and 
neck, dizziness and headache. When gradually increasing, imperfect 
articulation, loss of' memory and speech, inability to protrude the 
tongue in a straight line and the corner of the mouth drawn down 
or one half is drawn towards the healthy side. Numbness is also a 
symptom. When the spinal cord is injured or there is hemorrhage 
in the cord, all the body below the point of injury is palsied. At 
the small of the back there follows a staggering gait and sometimes 
walking and even standing are impossible ; the urine and excrement 
are passed involuntarily. At a higher point digestion and respiration 
are disturbed and labored, and still higher, the arms fall motionless. 
It is distinguished from apoplexy by its occurring sometimes with- 
out coma and by immobility being more permanent, while in apo- 
plexy there is coma, which is followed by a gradual restoration of the 
power of motion. In apoplexy and softening of the brain paralysis 
is, and in fact always is, a symptom of disease at head-quarters. In 
shaking palsy the trembling is regular and rythmical; in chorea the 
movements are irregular and jerky. 

TREATMENT. 

Not all cases are amenable to medicinal influences. In sudden 
strokes, keep the head high, the feet low and warm. To relieve the 
congestion of the head and diminish the volume of serum (water of 
the blood) take 

1$. — Podophyllin, two grains. 

Cream of Tartar, two drams. 

Mix. 

Make into four powders after thorough mixing and give one every 
two hours until free operation. The bed-pan should be used. 
Smelling s ilts (ammonia) and emetics are dangerous and must not 
be employed. Phosphorus and strychnia are the special remedies 
for all forms of palsy. We doubt if the following pill can be ex- 
celled, if equaled. 
16* 



370 MEDICAL PRACTICE. 

I£. — Phosphorus, .... one grain, 

Extract of Nux Vomica, . . twenty-five grains. 

Mix. 

This, with the addition of a fatty menstruum, will make one 
hundred pills. The dose is one, two or three after meals (one or all) 
and never upon an empty stomach. The results are remarkable. 
An alterative and tonic will also be of service. Electricity is valu- 
able, properly applied, which it is not one lime in ten. The man- 
agement of paralysis following such a condition is foreshadowed in 
the essay upon softening of the brain. 

Nerve-pain. — Neuralgia. 

Neuralgia is a common term signifying pain in a nerve. It is 
sharp, sudden, piercing, or lancinating, alternately ceases and reap- 
pears, and follows the course of a nerve and its branches. But few 
of the sensory nerves seem to be exempt. It attacks the nerves dis- 
tributed to the forehead and temple, the cheek and eye, the teeth and 
jaws, the arm, the heart, the ribs, the stomach, the liver, the kidney, 
the testicle, the leg (sciatica), and other parts. Hemicrania of the 
head, angina of the heart and sciatica of the hip joint and leg we 
have discussed otherwheres, (see Index). It is experienced by the 
strong and fuil-bloodcd (sthenic), as well as the feeble, delicate and 
anaemic (asthenic). Among the latter it is most frequent, particularly 
if inhabiting malarial districts. By many people neuralgia is called 
rheumatism, and it is sometimes difficult for a physician to distinguish 
between the two. In the jaws it may be mistaken for tooth-ache and 
many sound teeth have been extracted without relief. Nursing long 
continued and consumption induce neuralgia of the ribs (intercostal). 
Exposure to cold and damp produces neuralgia of the back and tes- 
ticle, and sciatica among the laboring classes. Neuralgia arises from 
dyspepsia, from uterine disease, and from other organic affections; 
often it is due to irritation and may be sympathetic. 



NEURALGIA. 371 

TREATMENT. 

From a moment's consideration of the many conditions in "which 
neuralgia appears and the many causes which produce it, it is evident 
that the only way to eradicate it is by a thorough course of medica- 
tion which will correct every abnormity of the system and its fluids. 
That it is obstinate, all physicians declare, and particularly so when 
it runs in the family or is hereditary. 

To relieve the pain it may be necessary to give morphine or inhale 
chloroform. We would not advise either until local means had 
been exhausted. If the surface is cold, apply a hot compress; if hot, 
apply ice water. Whichever increases the pain lay aside and use the 
other. Sometimes only by trial can this be ascertained. For a be- 
number, we prefer 

I£. — Tincture of Aconite root, 
Tincture of Arnica flowers, 

Laudanum. . . . equal parts. Mix. 

Apply to seat of pain on cotton or Canton-flannel disk and cover 
with oil-silk or rubber-sheeting. Secure with bandage. Chloroform 
maybe used in the same mauner, holding the disk until the burning 
is unbearable; or oil of peppermint. We believe nothing is gained 
by burning or blistering. If local heat relieves, apply the rubber bag 
filled with boiling hot water, to the back; to the lower part of the 
spine, if the pain is in the abdomen or legs, and between the shoulder 
blades if the neuralgia is in the head or chest. 

Many and various are the remedies recommended for internal ad- 
ministration, and with results almost universally unsatisfactory. The 
reason is obvious; neuralgia, like many other affections, is treated by 
name and not according to the remote or exciting causes, the control- 
ling influences and the peculiar and special condition of the individual. 
Some of these will now be noticed. If the person is robust: 
I£. — Tincture of Gelseminum, . . . one ounce, 
Essence of Wintergreen, . . . one dram, 
Water, . . ... four ounces. 

Mix. 



372 MEDICAL PRACTICE. 

Give a teaspoonful every hour. If constipated, or the saliva is 

acid, give calcined magnesia, a teaspoonful in sweetened water every 

six hours until free catharsis. If rheumatic and the urine is scanty 

and dark-colored, 

1$. — Tincture of Colchicum Seeds, . . four drams, 

Spirits of Nitre, three drams, 

Acetate of Potash, two drams, 

Essence of Wintergreen, . . . one dram, 

Water, three ounces. 

Mix. 

Take a tablespoonful every two or three hours. If bloodless, 

(anaemic) with cold feet and hands, a foot bath and 

I£. — Tincture of Gelseminum, . . thirty drops, 

Chloroform, . ... one dram, 

Compound Spirits of Lavender, . one ounce. 

Mix. 

Take a teaspoonful every hour in a little water. From nervous 
exhaustion, excessive mental labor, deficient nerve power or feeble- 
ness and impaired circulation, 

1$. — Phosphorus, . . . one grain, 

Extract of Nux Vomica, . . twenty-five grains, 

Fat, sufficient quantity. 

Mix. 
Make one hundred pills. Take one after each meal. Electricity 
is also beneficial. 
When malarial or intermittent or recurring at regular intervals, 

I£. — Podophyllin, six grains, 

Leptandrin, twelve grains, 

Iridin, . . . two grains, 

Extract of Dandelion, . . sufficient quantity. 

Mix. 
Make twenty pills and take one night and morning. If asthenic 
use instead 



FACEACHE. 373 

"Sf. — Quinine, ...... two drams, 

Morphine, ...... three grains, 

Strychnine, ...... two grains, 

Arsenious acid, three grains, 

Extract of Aconite, .... twenty grains. 

Mix. 
Make sixty pills and take one every two or three hours, at the 
same time keeping the bowels regular by diet or calcined magnesia. 
"When face is pale, eyes dull, pupils dilated, there is no better remedy 
than the extract of belladonna in one-fourth grain pills, as noticed in 
essay upon headaches. 

From what has been said it is evident that not only does the treat- 
ment vary with the individual but it may require change in the same 
patient with the same neuralgia under different conditions or circum- 
stances. Diet and other hygienic means are, of course, not to be 
disregarded. 

Faceache. — Tic Douloureux. 

This is one of the most common forms of neuralgia and not unlike 
other forms seems to have but little effect upon the duration of life. 
The pain passes to the cheek, lower eyelid, upper lip and side of the 
nose, sometimes to the forehead and upper lid and the eyeball. In 
dental neuralgia the lower jaw is affected, the teeth, gums and tongue. 
The face or eyelids twitch and frequently become red and swollen 
and painful to the touch. The pain is interrupted and intermittent, face 
flushed or pallid, tongue coated, bowels constipated, appetite poor 
and rest and sleep disturbed. The face may ache between paroxysms. 
If the teeth are iuvolved no particular one aches, but all on one side 
in either the upper or lower set are paiuful. May have headache. 
Sometimes the eye becomes bloodshot, tears are copious and flow 
down the cheeks, or the saliva is increased in quantity. The pains 
may migrate from the forehead to the cheek or lower jaw and occa- 
sionally one side of the head is left and the other attacked. 



874 MEDICAL PRACTICE. 

TREATMENT. 

A general outline of treatment has just been given. But little fur- 
ther need be said of the particular form under consideration. If the 
teeth are decayed, have them extracted, but if not and they are pain- 
ful, fill the mouth with hot or cold water, whichever affords relief. 
After oiling the hair, the whole head may be wrapped in hot towels 
or blankets, renewing frequently. For other local and general man- 
agement, see treatment of neuralgia above given. 

Neuromimesis. 

This is a form of nervous disorder in which the patient imitates, or 
rather mimics, a disease, medical or surgical. One most common is 
neuralgia of the breasts. The slightest touch cannot be borne; even 
the slightest brush of a feather causes pain. If, however, the mind 
is diverted to some subject or object that will be deeply interest- 
ing, the gland can be roughly handled without pain or notice. We 
shall never forget a chronic case of feigned rheumatism of the joints 
of the hands. The hand was emaciated, but the joints remained 
large, probably from continuous manipulation. When "the pain 
ran up the arm " the member was treated to a mustard plaster its 
whole length. This was allowed to remain until extensive blisters 
arose. One of the compounds of potash had been taken for years. 
No difference in the feelings was observed, whether the finger was 
carefully moved or the whole hand abruptly, but accidentally, jostled. 
To relate her experiences was a favorite theme, and during the re- 
hearsal, the hand could be cautiously grasped with some force without 
pain. 

Stammering — Stuttering. — Balb uties. 

In "Crabb's Synonyms" these terms are thus accurately defined : 
"Stammering and stuttering are confined principally to the useless mov- 
ing of the mouth; he who stammers brings forth sounds, but not the 
right sounds, without trials and efforts ; he who stutters remains for 
some time in a state of agitation without uttering a sound. Children 



STAMMERING AND STUTTERING. 375 

vho first begin to read will stammer at hard words : and one who has 
in impediment in his speech will stutter when he attempts to speak 
n a hurry." They are more a habit than a disease, and are easily 
corrected. A correspondent to the "Chicago Medical Times" nar- 
rates his plan and experience, here introduced, in overcoming 

Stammering : "Go into a room where you will be quiet and alone. 
Get some book that will interest but not excite you, and sit down and 
read two hours aloud to yourself, keeping your teeth together. Do 
the same thing every two or three daj T s, or once a week, if very tire- 
some, always taking care to read slowly and distinctly, moving the 
lips but not the teeth. Then, when conversing with others, try to 
peak as slowly and distinctly as possible, and, make up your mind 
that you will not stammer. 

Well, I tried this remedy, not having much faith in it, I must confess, 
but willing to do almost anything to cure myself of such an annoying 
difficulty. I read for two hours aloud with my teeth together. The 
first result was to make my teeth and jaws ache — that is, while I was 
reading — and the next to make me feel as if something had opened 
my talking apparatus, for I could speak with less difficulty immedi- 
ately. The change was so great that every one who knew me re- 
marked it. I repeated the remedy every five or six days for a month, 
and then at longer intervals until cured." 

Another plan is to restrict yourself for three or four days to ab- 
solute silence ; then, with each expiration of the breath pronounce 
distinctly, first vowels, then consonants, then syllables, and at the 
end of the week, sentences. Continue this, only increasing the speed 
with great caution, ceasing and resting for a few moments when a 
mistake is made, until fluency is obtained. 

Stuttering is mastered by what is called physiological treatment. 
The " Scientific American" says : "Very great success is reported 
as attending the treatment of stuttering by purely physiological train- 
ing, according to the system of M. Chervin, of Paris. Three types 
of stuttenng are distinguished : First, that occurring during inspira- 
tion; second, stuttering during expiration; third, stuttering during 



376 MEDICAL PRACTICE. 

both these periods, and between breaths. The treatment is divided 
into three stages. The first involves various respiratory exercises, 
during which the pupil is first taught to make a long, full inspiration 
and follow it by regular, forcible expiration. Then the respiratory 
movements are made with various rhythms until they become full, 
regular and easy, instead of being jerky, labored and fatiguing. In the 
second stage of treatment, exercises with vowel sounds are substituted 
for the previous mute breathings, giving to each vowel the various mod- 
ifications of tone, pitch, duration, etc., heard in conversation. The 
third stage comprises exercises on consonants, alone and in combi- 
nation with vowels ; at first slowly, then rapidly, varying the duration 
and pitch of each syllable, and passing from words of one syllable to 
those of two and more. Prepared by these exercises, the pupil learns 
to articulate slowly and methodically short sentences, then longer 
periods and paragraphs, separating sentences, and always beginning 
with a deep inspiration. Twenty days of this treatment usually suf- 
fice for a perfect cure. " 



INFLAMMATION OF THE EYE. 377 



ORDER II. DISEASES OF THE EYE. 

The eye is one of the most delicately constructed organs of the 
body; it is laid in fat and protected on all sides, but its anterior aspect, 
by bone. So important is the sense of sight that any disease affect- 
ing the eye causes not unreasonable alarm and hastens us, as indeed 
it ought, to consult a good physician. What we have to say in this 
matter is necessarily limited in a work of this nature and meant 
chiefly to draw attention to possible results as well as to assist, to a 
limited extent, those beyond the reach of medical aid, or with affec- 
tions so slight as to be successfully relieved by personal efforts. The 
diseases involving the internal structures are always serious; so we 
confine our remarks to those of the lids and conjunctiva. This will 
include about half of the cases met in practice. Inflammation of 
the eye differs in no respect from inflammation in other parts of the 
body, and, in general, needs the same treatment. Filth is the cause 
in many instances. Cleanliness, pure air and good food are as neces- 
sary as medicine. When mucous or purulent discharges occur care 
almost constant is necessary to keep the organ free from the least 
accumulation. 

Inflammation of the Eye. — Ophthalmia, Conjunctivitis. 

A delicate mucous membrane covers that part of the ball of the 
eye that can be seen and is reflected upon the inside of the lids. Kept 
continually moist it allows the lids to move and the eyes to turn with- 
out friction. When this inflames it becomes red, painful, the lids 
swollen with red edges, and there is great intolerance of light. Dur- 
ing the night the eyelids are glued together by the mucous discharge. 
The subject turns from the light, keeps the lids closed or the face 



378 MEDICAL PRACTICE. 

covered with the hand or seeks the dark. There is an unpleasant 
feeling, as if dust was in the eyes. 

Such a condition as we have described may result from cold, from 
substances getting in the eye, burning by hot cinder and from blows. 
The lids should be frequently bathed with hot water, and, in the 
meantime, a wet but light compress bound on. In the morning 
bathe the lids until the glue softens and permits their easy separation. 

The disease may not stop here but increase, until a mncous catarrh 
is produce.!. This is continually discharged, and overrunning 
the cheek, iuflames the skin. The eye is more sensitive to light and 
upon separating the lids with the thumb and forefinger, the confined 
mucus escapes. The mucus may become thick and purulent. 
This is the more likely to follow in the scrofulous and syphilitic, when 
the matter comes from another eye similarly diseased, or in the new- 
born who first open their eyes in the discharges of the mother. The 
pain and inflammation are greater, the lids more red and swollen, are 
puffed up by the imprisoned pus, the blood-vessels are enlarged and 
readily seen when the eye is open, although for the most part they 
are kept closed. The danger is now extreme, pustules or ulcers into 
tlte cornea may form, and the result be permanent loss of sight or 
destruction of the eye. 

TREATMENT. 

In catarrhal and purulent ophthalmia constant care is necessary to 
keep the eye free from matter. It is poisonous and must be so re- 
garded. It will give the disease to otliers by contact or will involve the 
well eye if but one is affected. All cloths used for washing or com- 
presses must be burned upon removal. Brushes and towels must be 
handled with care and thoroughly washed in hot water containing 
sulphate of zinc or carbolic acid. 

^.— Carbolic acid, four grains, 

Sulphate of zinc, eight grains, 

Fluid extract of Golden Seal, . . two drams, 

Water, four ounces. 

Mix. 






OPACITY OF THE EYE. 379 



Dry the lids and cheek and having dipped the ends of the thumb 
and forefinger in pulverized resin to prevent slipping, separate the 
lids with a camel's hair brush .dipped in the above: wash the ball 
every two hours. If possible raise the lids and sweep under them. 
Keep a piece of lint or compress of cotton moistened with the same 
constantly over the eye. If the fear of light is so great that this 
cannot be done chloroform must be used by inhalation. 

Granular lids. — Trachoma. 

The inner surfaces of the eyelids, from the above disease and other 
causes may become covered with little fleshy elevations or excres- 
cences looking much like fish eggs. They keep the color of the men- 
brane, but when the upper lid is everted look pale or purplish. They 
inflame the eye by their scratching. The flow of tears and mucus 
is increased, but as the inflammation abates, is diminished. The 
vision is cloudy and sensitive. Drooping lids are of tea the result of 
granulations. 

TREATMENT. 

The profession agree that caustics are necessary for their removal. 
The sulphate of copper, carbolic, nitric or salicylic acid is employed. 
The elevations are carefully touched with some one of these, either 
in powder or solution, allowed to remain half a minute and then 
washed off with a fine brush and water. In about a week the opera- 
tion is repeated. 

Opacity of the Cornea. 

At the front of the ball of the eye is a transparent but hard coat- 
ing which is named the Cornea. It lies just behind the mucous 
membranes and is separated from the colored membrane, the Iris, 
by a watery fluid technically termed the aqueous humor. The 
Cornea is subject to inflammation, to irritation from granulations 
and ingrowing eye-lashes and to ulcerations as we noted when speak- 
ing of ophthalmia. When inflamed fibrous matter is deposited, it 



380 MEDICAL PRACTICE. 

gives it a milky " ground glass " appearance and cuts off the light 
from the eye. When this opacity does not involve the whole cornea 
the person is only partially blind, having lateral vision. Objects ex- 
actly in front of the eye cannot be seen, but may be distinguished if 
held to one side. Vision is interfered with in proportion to the 
density of the deposit or its extent. This opacity must not be con- 
founded with cataract, which is opacity of tJie crystalline lens. This 
lens lies behind the pupil, the circular opening in the Iris. In health 
it is perfectly transparent, in cataract it is opaque and can be seen 
behind but close to the pupil. The blood-vessels of the eyeball are 
usually enlarged in corneal opacity and can be plainly seen ramify- 
ing through its substance. 

TREATMENT. 

The ball of the eye must be frequently brushed with the sulphate 
of soda dissolved in w T ater, as much as it will take up. It may be 
used in powder form; in either case its use must be continued for 
weeks, perhaps months. We have seen cataract benefited by the 
long continued use of phosphorus in minute doses. Usually it is 
removed out of the line of vision by the surgeon. 

Amaurosis. 

This is "impairment or loss of sight from disease of the retina, 
optic nerve, or part of the brain with which the optic nerve is con- 
nected. If the retina only be affected, it cannot receive the impres- 
sion which should be transmitted by the optic nerve to the brain ; if 
the optic nerve only be affected it cannot transmit the visual impres- 
sion from the retina to the brain; — if the brain alone be affected the 
sensorial pow r er to take cognizance of the visual impressions trans- 
mitted by the optic nerve is lost. The result is the same whether 
the different parts of the optic nervous apparatus be affected to- 
gether or separately. The symptoms are very various and inconstant. 
Amaurosis must not be considered as a special disease, but merely a 
symptom of different affections of the optic nervous apparatus. 



COLOR-BLINDNESS. 381 

Each particular case must therefore be specially studied by the phy- 
sician in reference to its causes, diagnosis and treatment. For this 
purpose, exploration of the interior of the eye by means of the oph- 
thalmoscope is necessary." 

Color-blindness. 

" Cases occur and that more frequently than is generally sup- 
posed, in which persons are unable, in different degrees, to distin- 
guish certain colors, their sight in other respects being natural. The 
colors most generally confounded are red and brown with green, 
and pink with blue. Yellow and blue are generally readily distin- 
guished by the color-blind. 

The affection appears to be in most instances congenital. Ac- 
quired color-blindness, however, sometimes presents itself as a symp- 
tom of incomplete amaurosis. Yellow discol orations of the humors 
of the eye I have found do not interfere with the correct perception 
of colors. 

Color-blindness has been met with much of tener in males than in 
females. It runs in families and like other hereditary complaints, 
sometimes overleaps one generation or more. 

The most practical disadvantage attending it is the possibility of 
confounding red and green signals on railways or at sea, a mistake 
which might entail mo=t disastrous consequences. 

Congenital color-blindness is incurable. One method by which 
the false judgments of the imperfect sense may be corrected is the 
comparison of doubtful with known colors, by carrying about a chro- 
matic scale, accurately tinted and named. This however is avail- 
able only to a limitel extent — that is as far as the colors of the scale 
itself can be distinguished." — (Jones) 

Ophthalmia Tarsi. 

The edges of the eyelids are subject to chronic and obstinate in- 
flammation. They appear red continually and on account of the 



382 MEDICAL PRACTICE. 

itching, are rubbed with the handkerchief and finger nails, "which 
retards recovery. The lids become agglutinated during the night. 
Scales sometimes form along the borders of the lids and at times the 
lashes fall out. 

TREATMENT. 

This is usually unsuccessful because the discharge adheres to the 
roots of the lashes and forms crusts which prevent remedies from 
gaining access to the inflammatory part. The quickest mode of cure 
is to remove all the hairs. Each may be extracted in turn by a jerk, 
using the forceps to get a single but good hold. Two or three re- 
movals, at intervals of two weeks, are necessary. The hairs grow 
again very quickly and in about six weeks attain their normal growth. 
After removal, the lids may be brushed morning and evening with 
the carbolic acid, zinc and golden seal mixture just given. 

Ingrowing eyelashes are the source of great annoyance to some and 
should be removed in the same way. They inflame the eye and may 
produce opacity of the cornea. 

Styes. — Hordeolum. These are little boil-like tumors, located upon 
the edge of the eyelid. Treat by bathing the edges of the lids with 
tincture of myrrh and water, equal parts. Apply a compress wet in 
the same at night. 

Watery eyes may result from obstruction of the tear duct, a tubule 
which carries the tears into the nose, or from overflow of the duct 
and lower lids, as by the introduction of foreign substances into 
the eye, diseases of the stomach and dissipation. It is usually a sign 
of debility. The system needs attention. Subdue inflammation 
about the eye or lids. 

Malposition of the Eyes, Squinting, Cross eyes. — Strabismus. 

This is sometimes congenital and sometimes acquired by imitation. 
There is a want of the natural parallelism in the position and motion 
of the eyes. Sometimes both eyes squint, but not at the same time. 
The internal muscle of the eye is the usual offender. It is shorter 
»nd stronger than its opposite. 



SQUINTING. . 383 

TREATMENT. 

This mi sightly deformity is sometimes amenable to cure by edu- 
cating the weak tje to take its proper place. Cover the sound eye 
and look steadily at an object. Then remove the cover. The eye 
will diverge. Repeating this operation for some time each day it will 
be observed that gradually the divergence diminishes. The surgical 
operation consists of the complete division of the shortened muscles. 
It is a quick and almost painless method of removing a striking de- 
formity. 

Foreign Bodies in the Eye. 

Fine dust that will float in the atmosphere will become moistened 
and collect in the corner toward the nose where it can be removed 
by the finger-tip. Sand and cinders are more obstinate, do not soften 
with moisture, and hence each particle must be separately removed, 
They will be found upon the ball or lid. The motion of the upper 
lid causes their sharp edges to cut and scratch both the lid and the 
ball. Pressure upon the lid, while it relieves this motion, fastens the 
object more firmly in the delicate tissue. The lower lid can be easily 
everted by placing the finger upon the cheek just below the lid and 
drawing downwards. A fine brush or camel's hair pencil drawn 
across it will usually sweep them out; if this does not remove all the 
particles, those remaining should be disturbed by some sharp instru- 
ment, like the blunt end of a needle, and the brush again be used. 

Most particles collect under the upper lid. This lid should be 
folded in two upon itself, the lower half turned over and resting upon 
the upper. To accomplish this have the person look at the ground 
just in front of him. Wi h a knitting-needle, a round stiff piece of 
wire, a lead pencil, or some such thing, apply slight pressure along 
the middle of the lid. With the other hand grasp the eye-lashes, 
which will separate easily from these of the other lid, and turn the 
lid over. Withdraw the article used for pressure: the lid will remain 
turned outwards, the particles may be easily seen, andean be k moved 
as above described. 



384 . MEDICAL PRACTICE. 

Steel points, emery, and the like, which are thrown with much 
force against the eye, usually penetrate the membrane, and are with 
difficulty removed. In the case of the former, the load-stone is the 
best instrument for removing them. In the latter case, they should 
be immediately removed by the point of a ne-dle, holding the lids 
apart with the thumb and fore-finger. Great care must be taken lest 
the eye be injured by a jerk or other sudden movement of the pa- 
tient Some parties are unable to keep the ball quiet while under- 
going this operation. Under such circumstances a physician should 
be consulted and an anaesthetic administered. Bodies penetrating 
beyond the cornea require the surgeon's care. 

When a piece of lime enters, it should be removed instantly, and 
the ball be thoroughly washed. This is the more important if the 
lime is unslaked. The wash should consist of simple water or be 
slightly acidulated with vinegar, which is better. 

Smokers' Eyes. 

Inveterate smokers have the pupils of the eyes very much dilated, and 
always more or less pain in the eye, luminous specks, bright images, 
etc. ; when reading the lines dance ; after looking at a bright light 
an image of it often remains for a few minutes. These symptoms 
gradually disappear when the smoking is stopped. As the particles 
of smoke impinge on the eye, they cause a very disagreeable feeling 
in non-smokers, and even smokers are seen to close their eyes against 
it. Now, as the smoke comes in contact with the eye it is ab- 
sorbed by the moist ball, and the nicotin of the tobacco is carried 
into the eye. It is this nicotin that causes the dilatation. It partially 
paralyses the muscular fibres of the iris, so that they cannot contract 
and reduce the size of the pupil, so it may adjust itself to different 
amounts of light. Where the light is low, little harm is done ; but in 
a bright light, the eye may be seriously injured. Those who value 
their eyes should not smoke. 



PRESERVATION OF THE SIGHT. 385 

Protection of Vision. 

A resume of foreign authorities on the preservation of eyesight 
lately appeared in the Journal of Chemistry: — 

" For the worker the light should come as much as possible from the 
left side, that is to say, from the side towards which one turns in 
working. Daylight is the best; but direct sunlight and that reflected 
from mirrors should be avoided. The aspect should be northern 
and the light should come a little from above. 

White walls should be avoided ; highly varnished tables and in 
work-shops shining articles like silk should be protected from the 
sun's rays. 

Artificial light is always bad, on account of the heat and the ex- 
halation of carbonic acid. The best is that of lamps f d with vege- 
table oil (much used in France, but seldom in this country) and fur- 
nished with a glass shade. Gas is bad because of its heat, brilliancy 
and mobility; the light of mineral oils is too hot; that of candles 
insufficient and flickering. The eye of the workman should avoid 
the light coming to him directly or diffused through the room. 

Working immediately after meals is objectionable; also uninter- 
rupted use of the eyes for long periods of time. One should 
write on an inclined plane and not keep the head bent down more 
than is absolutely necessary. Reading in bed is bad every way. 

Some good authorities commend washing the eyes with cold 
water, but the majority of the best ophthalmologists advise the use of 
hot water for the less serious affections of the eye. For tired eyes 
we believe, from our own experience, that water, hot as can be borne, 
is refreshing and beneficial. 

If the eyes are fatigued by bad artificial illumination, blue or 
slightly smoked glasses will be useful, and in order to avoid the 
lateral rays they should be large and round. 

If the irritation of the eyes persists, all work must be abandoned 
and an examination made to see if there be any disturbance of refrac- 
tion, of power of accommodation, or of the mobility of the eyes. 
17 



886 MEDICAL PRACTICE. 

Presbyopia, or so-called ' far-si uhtedness,' supervenes earlier with 
those who are constantly at work than with other individuals, and as 
soon as it does convex glasses should be at < nee resorted to, without 
which the muscle of accommodation would be fatigued to no purpose. 
At first they should be used for working in the evening after the 
"atigue of the day; but a long-sighted person should only use specta- 
cles for looking at near objects, not at far ones. 

Work requiring close application favors the development of my- 
>pia or ' near-sightedness,' precisely as the conditions of illumination 
are bad. If the action of those causes continues, the myopia will 
increase until vision is lost. 

A slight degree of myopia may be favorable to such work ; but, 
as a general rule, work requiring close application, by the derange- 
ment of circulation that it inevitably produces in the eyes, is much 
more injurious to the myopic, and is the great cause of the develop- 
ment of myopia and its complications. Young people should be ex- 
amined, and, if they are myopic, hindered from undertaking tedious 
studies, and all professions demanding close application of the eye." 

Dr. Spaulding, who has made a special study of defective vision 
in school-children, says : 

" The only place to teach children how to use their eyes well — how 
not to abuse them — is at home. They should be taught that the 
light should always come from the sid<', or even over the shoulders ; 
that the book should be held up, if possible, and never in the lap ; 
that they should always have a shade over a lamp standing on a 
table at a level with their eyes, and especially if they have to face the 
light, as in writing ; and that all bending positions, and reading in 
th- twilight, or with the sunlight pouring over the book, are very 
harmful to the eyes. It is wrong to accuse the schools as the sole 
cause in all cases of short-sight. Hereditary influence I believe to be of 
gnat effect in causing short-sight ; while bad light at night at home, 
poor light in the school rooms, want of care in selecting well-printed 
books, urging girls too much to do fine sewing and embroidery, too 
long-continued and uurested work at school, too strong glasses given 



SHORT-SIGHT. 387 

by opticians, and many bodily ails and weaknesses, as scarlatina and 
measles, are other factors, always busy in producing and continuing 
short-sight, all of which may, with care and thoughtfulness, be to some 
extent, obviated, and naturally at no better time than during the 
years at school." 



888 MEDICAL PRACTICE. 



ORDER III.— DISEASES OF THE EAR. 

The diseases of this important organ are numerous, few of them 
however being amenable to domestic treatment. For a better under- 
standing of its anatomy and pathology the ear is divided into thr e 
parts, called the internal, middle and external ear. The portions 
that more particularly concern us are the internal and external. 
From the pharj'nx (ihroat) is a canal called the eustachian tube 
which terminates in the internal ear and tympanum or drum of the 
ear. The external ear consists of the trumpet shaped organ upon 
the side of the head with which we are so familiar and the canal 
leading directly into the hea i about an inch in length and covered 
at its end by the tympanum or drum. Iu most persons the drum 
can be seen if the observer will straighten the canal by gently pulling 
the ear upwards and outwards. The physician generally uses for 
the purpose a polished tube or speculum and a mirror to reflect and 




EAR BPECUI.T71L. 

concentrate the light. The internal ear is one of the wonders of the 
body, so delicate and intricate is it in its mechanism. Any and all 
portions of the auditory apparatus are subject to inflammation, in- 
jury, morbid growth and perverted function. A few of these will 
be briefly mentioned. The external canal may be inflamed, swollen 



INFLAMMATION OF THE EAR. 389 

to closure, obstructed by foreign bodies and insects, its membrane 
thickened, ulcerated or may discharge in abnormal quantities mucus, 
pus or wax ; the drum may inflame, thicken, perforate or become 
punctured by accident, be the seat of diseased growths, either fun- 
gus, polypus or tumor or be so thickly covered with cerumen (wax) 
as to be inoperative ; the eustachian tube maybe closed by inflam- 
mation and swelling, by pressure from swollen tonsils, by mucus 
(catarrh) or stricture ; the internal ear is subject to catarrh, suppura- 
tion and decay of the bones from catarrh of the h( ad reaching it or 
resulting from measles or scarlet fever. Most of these maladies 
affect the hearing. Add to these malformation, and it is evident 
that the successful treatment of deafness requires superior skill and 
intelligence. Tumors, fungus and polypus in the ear are relegated 
to the hands of the specialist or surgeon. With this much by way 
of introduction, we are now prepared to introduce some of the more 
common and less formidable complaints of the ear. 

Inflammation of the Ear. — Otitis. 

As above observed, this may involve any part of the structure or 
beginning in one part may spread and affect others. Most com- 
monly it is the result of a cold. It is " characterized by pain in the 
part, which is increased by pressure and by noise as well as by the 
motions of the head and of the lower jaw and by exposure to cold 
air." Headache, uneasiness, some fever and ringing of the ear ac- 
companies it. 

TREATMENT. 

If caused by a recent cold, the Turkish or spirit vapor bath should 
be administered. The internal remedy most effective is, 

1$. — Tincture of Veratrum Viride, . . twenty drops, 
Essence of Wintergreen, .... ten drops, 

Water, . . , ten teaspoonfuls. 

Mix. 
Take a teaspoonful every hour or two. A mustard paste may be 



390 MEDICAL PRACTICE. 

applied to the h^ad behind and under the ear, removing it when 
the surface is well reddened. A hot pack, we'l sprinkled with 
spirits of camphor, may be applied to the side of the head, com- 
pletely enveloping the ear, and secured by a bandage. The bandage 
may be made of a strip of cotton cloth, six inches wide and thirty 
inches long. Tear the ends in two toward the center about ten 
inches. Place the undivided part upon the crown of the head, the 
ends hanging down by the ears. Bring the back ends forward and 
tie under the chin ; the forward ends tie under the back of the head. 
If the back knot slips, pass a ribbon through the noose and tie around 
the neck. 

Earache, in a majority of cases, is due to inflammation, and may 
be treated in the way just described. If the pain is severe, adults 
may have dropped into the ear a mixture of equal parts of olive oil 
(warmed) and laudanum, and the opening closed with cotton wool 
dipped in the same. 

Impiasated Cerum<m.,OT hardened wax in the ears,comes about slowly 
and covers the drum. In time there is pain, constant or occasional, 
defective hearing, and a stopped-up feeling. If, upon inspection, an. 
excess of wax is found covering the external canal, it may be in- 
ferred that the drum is also covered. The head should be turned 
sideways and a few drops of warm glycerine or olive oil dropped in. 
If allowed to remain twenty-four hours, the cerumen will soften and 
be easily removed by a syringe with soap and warm water. 

Running from the Ear. — Otorrhea. 

This results from long-standing inflammation, may follow measles 
or scarlet fever, may arise in an} r portion of the ear, and is more 
prevalent in the debilitated and scrofulous. The discharge is some- 
times mucoid, somet mes purulent or bloody, and may find vent 
internally into the throat, or, if from the middle or external portions 
outward through the external opening. When the disease is located 
in the middle ear, the drum is frequently perforated ; there is severe 
pain in the ear, and a sense of fullness, ringing noises, inflamed drum, 



RUNNING FROM THE EARS. 391 

impaired hearing, and usually pharyngitis and nasal catarrh. The 
popular treatment of nasal catarrh by the douche is a frequent cause, 
we might say, the most frequent. 

TREATMENT. 

When fetid discharges follow inflammation of the external ear, r.s 
is frequently the case with children, drop into the ear a few drops of 
a mixture composed of 

1$. — Tannin, . . . . . two grains, 

Glycerine, one ounce. 

Mix. 

Also, plug the ear with a piece of cotton wet with the same. "Wash 
out with tepid, soapy water daily. If this is not done the membrane 
becomes covered with a dry, hard crust, which adds to the pain and 
inflammation. When possessing an atomizer, (see illustration in 
Catarrh), these applications can be m.-ide in the form of spray, which 
is far preferable in every way, chiefly because in the hands of a nurse 
it is not so likely to do harm. 

In the chronic form the treatment must be continued regularly and 
for a long time, and even then may be intractable. Use two or three 
times a day with the atomizer, 

V,. — Carbolic Acid, .... five to ten drops, 
Water and Glycerine, . . . four ounces each. ' 

Mix. 
Alternating every third day with 

~Bf. — Sulphate of Zinc, . . • . five to ten grains, 

Warm water, . . . . . four ounces. 

Mix. 

The mustard paste should be frequently applied to the head behind 
the ear. If it should occasionally blister only good will result. Al- 
teratives, such as the Queen's root compound, are indicated in chronic 
catarrhs of the ear; when the glands at the ^ides of the neck are suffi- 
ciently enlarged to be felt upon pressure by the finger-tips, take of 



392 MEDICAL PRACTICE. 

R.— Fid. Ext. Blue Flag, . . . .six drams, 
Fid. Extract Poke Root, . . .six drams, 

Fid. Ext. Mandrake, .... four drams, 

Simple Syrup, six ounces. 

Mix. 
One-half or a full teaspoonful three times a day. 
Cases in which catarrh of the eustachian tube is the chief cause 
of deafness or other car difficulties, we are accustomed to treat simply 
as catarrh of the head, with which it is so often associated. It is 
generally known that disease is transmissible, but not so well under- 
stood that health is contagious. With blood purified and the con- 
tiguous membrane in a healthy condition, this tube often heals with- 
out any special treatment. 

Foreign Substances in the Ear. 

Children have quite a habit of putting beans, peas, cherry-stones, 
beads and the like, in the no?e and the ears. To most who have not 
considered the subject, the removal seems difficult. Inexperienced 
physicians are sometimes puzzled. The great fault seems to lie in 
using instruments for the purpose of pulling out the obstruction, the 
result b< ingthat it is pushed in until it presses upon the drum, causing 
great pain. Nothing should be introduced unless perhaps two or 
three drops of oil. Place the child upon your knees, with the ear 
containing the article downward, and by a sudden blow upon the 
head just above the opposite ear, it will usually fall to the ground. 
Sometimes a second blow is necessary. Should this fail, a thin wire 
loop may be passed behind the substance with great care and by 
traction, removed. Insects are best removed by filling the ear with 
warm oil, when they will float to the surface. 

Substances introduced into the nose may be removed by several 
methods. One is to place the child face downwards upon your lap, 
closing the mouth with one hand and strike a sharp blow upon the 
back of the head with the other. Another is closing the free nostril 



INSTRUMENTS FOR DEAFNESS. 393 

with the finger (which compels the child to breathe through the 
mouth), take a deep inspiration and suddenly and forcibly blow into 
the child's mouth. Do not attempt to extract them with instruments. 




Pig. 4. 

Cornet, Ear Trumpets and Conversation Turk. 
Pig. 1. Ear Trumpet— double curved. 
Pig. 3. Ear Trumpet— articulated. 
Pig. 2. Silver Cornet. 
Fig. 4. Conversation Tube— mohair with hard rubber fittings. 



17* 



394 MEDICAL PRACTICE. 



ORDER IV. DISEASES OF THE NOSE. 

CATARRH. — Oz^ena, Influenza — Catarrhm Nasalis. 

This disease prevails to a great extent throughout Europe and 
America. It is more extensive in cold than in warm countries, and 
it is more frequently met with in New England and the Middle States 
than in the South and West. Those whose labors are within doors 
and who are confined to the heated air of cotton or other mills; those 
who are breathing an atmosphere loaded with dust of any material 
are the principal sufferers. From the fact that it leads to such serious 
effects, producing bronchitis and consumption, so often defying the 
skill of the most eminent physicians, it should receive more than 
usual attention and consideration. Most m< dical works speak of 
catarrh as a slight disorder easily cured. Many affected with it have 
tried almost everything spoken of as remedies, but without success. 
With similar results the advertised specifics have been administered, 
and even a doubtful medicat'on received at the hands of special- 
ists. It is therefore, with more than usual pleasure that we confi- 
dently recommend a plan of treatment that has permanently cured the 
majority of cases and given decided relief to all. 

As remarked in another place, catarrh usually begins in the 
pharynx or throat, and extends upward into the air passage of the 
head and nose. It may be defined as an inflammatory affection of 
the mucous membrane of the respiratory passages. We have at this 
time only to consider what is termed catarrh of the head, snuffles, or 
permanent snuffles. The principal symptom is the excessive se- 
cretion about this membrane of mucus ; sometimes thin and watery, 



CATARRH. 395 

particularly at the outset, at other times, thick, clotted, tenacious and 
offensive ; varying between these two. It begins, in most instances, 
as a slight cold, requiring the frequent use of the handkerchief. 
When seated, the discharge has a firmer consistency, and may be ex- 
pelled by one of the nostrils or throat, moi e frequently the latter. 
An uneasy sensation is felt in the throat, and the operation employed 
in discharging it demonstrates whether it is above or below the pal- 
ate. If above, it will be noticed that by a strong and sudden effort 
air is drawn through the nose. Then hawking takes place, and the 
clot is discharged through the mouth. This is a sure sign of catarrh 
of the head. When it comes from below the palate, a cough is neces- 
sary to loosen it, while the former is seldom accompanied with 
cough. 

Simple catarrh is usually produced by a cold, and this is true of 
catarrh of any of the mucous membranes, not excepting diarrhoea. 
This is not, however, the only cause. Irritating substances bring on 
an attack ; weakness of the membrane and general debility are, also, 
sources of the affection ; impurities in the blood not only cause a 
vitiated secretion, but help to prolong if. A fact equally worthy of 
notice is that the discharge, by its debilitating effect, contaminates 
the blood and weakens the system. In some families it is hereditary. 
Some persons suffer from it when debilitated by the hot weather of 
spring and summer, and are relieved when the temperature is cooler. 
This is a symptom of physical weakness, and is quite different from the 
catarrh in question, which increases in cold weather. We doubt 
very much if any peculiar condition of the atmosphere generates the 
disease, but fully believe that frequently " taking the breath" of 
those infected, or inhaling the dust of sputa which has become dried, 
pulverized, and mixed with the air, is infectious. 

In addition to those already mentioned there are other S}nnptoms, 
special and prominent. There is a continual desire to swallow, and 
large quantities of this decaying phlegm are passed into the stomach. 
Something sticks in the throat and may annoy to such an extent as to 
deprive a person of sleep at night. Breathing is carried on through 



396 MEDICAL PRACTICE. 

the mouth and the breath is offensive. There is pain in the forehead 
between the eyes. This is caused by the enlargement and congestion 
of the blood-vessels that follow the nerves of smell through the sieve- 
like bone into the brain. This enlargement causes pressure and pres- 
sure is indicated by pain. The membrane, lining all parts of the 
nasal cavity, becomes thickened and that part upon which the delicate 
fibres of the nerves of smell are spread, becoming involved, this sense 
is blunted or destroyed. The sense of taste with which smell is so in- 
timately associated may be similarly affected. The canal leading into 
the inner ear is lined with mucous membrane which is continuous 
with that of the nose, and if the catarrhal inflammation spreads in 
this direction, and it very frequently does, deafness may result either 
in one ear or both. So excessive is the secretion of mucus in some 
cases that patients are spitting it from the mouth constantly; nausea 
and vomiting frequently attack a person in the morning on rising, 
produced undoubtedly by the mucus which has collected in the head 
and throat and which irritates the palate in a similar manner to the 
introduction of the finger. 

Thickening of tbe membrane is not the only condition. Ulcers may 
locate on any part of the membrane and discharge purulent matter or 
matter mixe-1 with blood; or if a blood-vessel is ulcerated, hemorrhage 
ensues. Nor does this ulceration cease here. It denudes the bone 
of its covering and may destroy its substance. The bones of the 
nasal cavity are many, of peculiar shapes and mostly thin and fra- 
gile. With death of the bone the discharge becomes exceedingly 
offensive and the pain is severe and almost constant. This discharge 
ulcerates and inflames the surface over which it flows. Ulcers in the 
nose will sometimes cause unsightly sores upon the lip. If the bones 
are involved to any greit extent the voice becomes changed. Drow- 
siness, pain in the eyes and emaciation often attend this complaint. 
It is* not unfrequently followed by bronchitis and consumption. 

Almost every plan of treatment that human ingenuity can devise 
has been tried, and the medical profession have to admit, with little 
success. We will notice a few, and try and point out the causes of 



CATARRH. 397 

failure. Snuffs are of two kinds : one intended to produce sneezing, 
and thus cleanse the membrane; and the other composed of healing in- 
gredients. The first is ineffective, because cleansing is not all that is 
needed; the second, for the reason that it reaches but a veiy small por- 
tion of the part involved ; it may be deposited at one point, and there in 
quantities, while other parts are untouched. "Washes that are poured 
into the palm of the hand and snuffed up with force, cleanse but lit- 
tle, and bathe but a limited portion of the membrane. The douche 
is recommended by the majority, both professional and unprofes- 
sional. It consists of a basin filled with a medicated liquid, from the 
lower portion of which a rubber tube conducts to the nostril. The 
basin is lifted above the head and the flow is downward into one 
nostril, passing out of the other. This is unsuccessful because only 
the floor of the nasal cavity is washed by the current. These meth- 
ods do harm, also, by forcing the mucus into the eustachian tube and 
into the middle ear, causing great pain, producing hypertrophy of 
the lining membrane, and not unfrequently deafness. The records 
of ear infirmaries universally confirm this. A humbug of recent date 
is a catarrh inhaler. This consists of a bottle half filled with some 
liquid, principally alcohol mixed with strong ammonia. By the side 
of the tube through which the air must pass on its way to the fluid, 
is a bulb containing hydrochloric (muriatic) acid. The air passing 
along this tube carries with it the vapor of the acid. Passing into 
the fluid it mixes with the ammonia, forming a whitish cloud, which 
is the hydrochlorate of ammonia, (sal ammonia), in very fine par- 
ticles. It is taken into the mouth and discharged through the nos- 
trils. It is totally incapable of ever dHodging or penetrating the 
mucous clots, and bas a very limited effect in the healing process. 
Ozone is a good disinfectant, but is subject to the same objections. 
Syringes of different patterns are used, and throw a stream either 
backward through the nostrils, or are furnished with a curved neck, 
and propel the liquid forward from behind the palatine arch. From 
the amount of force used they very well cleanse all points touched 
by the streams, and then the liquid falls to the floor of the cavity and 



398 MEDICAL PRACTICE. 

passes out. The shape of the bones are such that with the use of 
both it is impossible to reach the whole surface. They have another 
fault. Owing to the velocity with which the injected fluid strikes 
the walls of the cavity of the nose, it creates pain, sternutation and 
lachrymation. Indeed, pure water in contact with the schneiderian 
membrane, causes stinging and smat ting pain. 

The indications are to reduce the swelling or thickening of the 
lining membrane of the nose, to relieve inflammation, to heal all ul- 
cers or sores, to keep the surface free from scales or scabs, to destroy 
offensive odor and induce a healthy tone, and hence break up the 
tendency to relapse. 

TREATMENT. 

This may be divided into local and constitutional. Neither one 
alone will permanently cure. As a constitutional remedy, we advise 
tonics to be taien, but varied according to the constitution of the 
patient. This may be better understood by citing examples. If the 
patient is of the scrofulous diathesis by hereditar}^ taint or other 
. cause, those remed.es are employed that will change the character of 
the blood and remove its irritating qualities ; if there is dropsy or 
torpidity of the liver, these organs must receive special attention. 
The rationale is that with the congestion of an internal organ there is 
an increased flow of blood to the organ, and with this congestion 
there is a disturbance in the circulation which, of itself, prepares the 
way for taking colds. Again, with constipation and inactive kid- 
neys, the skin performs double duty. The mucous membrane is but 
a continuation of the skin, ami the excretion of foreign matters over- 
works, and, as a result, weakens it. The weakened and flabby mem- 
brane promotes catarrhal inflammation. Space will not allow the 
insertion of all the diseased conditions or of the special remedies for 
their constitutional treatment. 

An active and healthy condition of the skin is absolutely necessary. 
The occasional use of the Turki>h or spirit bath tends to relieve in- 
ternal congestions and invigorates the surface. If these baths are 
followed by proper rest and cooling and the use of cold water, inimu- 



CATARRH. 899 

nity from colds is secured. A good plan that can be adopted by 
every one is daily bathing the chest with cold water. The application 
should be made with the hands on rising, and if the partis sensitive 
to cold water, it should be begun in the summer time. The chest 
above the waist is quickly wetted and subsequently dried with a 
coarse towel, using some friction. The time consumed need not ex- 
ceed three or five minutes. The relief to the lungs is considerable, 
and to a person adopting such a habit, winter loses much of its se- 
verity. We have been thus particular in speaking of guarding 
against colds, because treatment is unsuccessful without it and dis- 
couragement follows the frequent relapses caused by them. 

Local means, to be effective, must reach all parts of the mem- 
brane, no matter what remedies may be employed. The only excep- 
tion is where a local effect is desired, as in the case where phlegm is 
tenacious and clings to the throat, when snuffing warm water com- 
bined with a little salt, will free it so as to be discharged through the 
mouth. There are but two plans that we consider effective in local 
treatment; one by throwing a stream into one nostril by means of a 
hard rubber syringe having a properly fitted point and fine orifice. 
The fluid not only cleanses the parts, but accumulates in the nose 
and is prevented from returning by the syringe. The head is in- 
clined a little backwards and the breath held. When the fluid begins 
to overflow from the open nostril then the nose should be held be- 
tween the thumb and finger, the syringe removed, and the body 
botfed forward until the forehead comes to the knees. Holding this 
position a very short time the natural position may then be resumed 
and the fluid allowed to escape. In this way all parts are subjected 
to the action of the medicated fluid. 

Another plan, not only the most important but the most effective 
and attended invariably with good results r is the use of my Nasal 
Atomizing Instrument. This consists of a bottle partly filled with 
the remedy hereafter mentioned. Passing from beneath the surface 
of the fluid is a tube which arises through the cork and terminates in 
the curved neck and bulb point. Just above the cork is an attach- 



400 



MEDICAL PRACTICE. 



ment to a tube surrounding this tube. This outer tube is raennt to 
carry air, and by its forced expulsion *t the point draws the fluid up 
and scatters it as a fine mist. A part of the air supply passes into 
the vial and pressing upon the surface of the fluid forces through a 




Atomizer or Bpray apparatus, with hand-bulb and covered reservoir. By the latter 

a continuous spray is produced. 

greater quantity of the medicament than the other instruments made 
for the s.mc purpose. The air is supplied by a rubber pipe and 
elastic hand-bulb. In order that the spray may be delivered uni- 
formly, an air chamber is placed between the hand-bulb and the in- 
strument. The hard rubber point at the end of the main tube is 
adjustable. This allows of its removal in case of clogging, and 
nlso permits the attachment, of other pieces. 
There are three of these, one meant to throw a spray into the 



CATARRH. 



401 




Air Pump and Receiver, used by the physician so as to dispense with the manipu- 
lation of the hand-bulb. 

nasal cavity, through the nostril, the second into the same cavity 
from behinl the palate and the third downwards into the throat and 
air passages. To say that the application is mild, hardly expresses 
the soothing effect produced. Even a child is pleased with it, and 
takes the author's chair with a cohfldence of relief that is as pleasing 
as it is surprising. The principal recipe employed consists of the 
following : 

I£. — Tincture Fleabane, 
Tincture Aconite, 

Tincture Veratrum Viride, of each two drams, 
Tincture Pennyroyal, . . . half dram, 
Carbolic acid, . . . . forty drops, 
Chlorate of Potash, . . . one ounce, 
Rain water, .... two pints. 
Mix and put two ounces in the bottle. 
If the patient is subject to hemorrhage, more fleabane is added. 



402 MEDICAL PRACTICE. 

If tha inflammation is severe more veratrum is added, the other ingre- 
dients remaining the same. If there are ulcers, the aconite is with- 
held and the carbolic acid increased. In cases where the membrane 
is mu 'h inflamed and the mucus is acrid, and irritates the skin of 
the nostrils and upper lip, we omit the fleabane, aconite and penny- 
royal, aud add 

Glycerine, one ounce, 

Tincture Golden-seal, . . two drams. 

In severe cases the application should be made daily, and con- 
tinued for some ten minutes. In the milder cases the daily applica- 
tion of about five minutes will be necessary only during the first 
week. A sitting of fifteen minutes every other day, for a fortnight 
following, will complete the cure. After each use, the instrument 
should be carefully cleansed and dried. Ulcers in the nostrils and 
upon the lips are treated with pure glycerine. 

Recovery is more rapid, and requires much less care during the 
warmer months of the year, than in winter. The treament has been 
successful in our hands at all seasons; but in cold weather a lady 
should use a heavy veil to cover the face when going out doors. A 
gentleman must also protect the membrane from too sudden chill of a 
low lemperature; and we have found that the best protection is by 
wearing an overcoat supplied with a cape. This may be raised by 
the arm or hand about up to the eyes. The air is by this means par- 
tially warmed before it reaches the head. In ten minutes or so the 
head will be sufficiently cooled, when this protection may be dis- 
pensed with. 

We have reason to believe that nasal polypy have yielded to treat- 
ment by this instrument, when a strong solution of tannin has been 
employed. In rases attended with necrosis or diseased bones, a 
mild solution of sulphate of zinc has been us^d successfully. It does 
not appear to be adapted to the cure of diseases of the antrum. 



DISEASES OF THE NOSE. 403 

Nasal Polypus. 

This is a morbid growth inside the nasal cavity, commonly fas- 
tened to the bone on one side. When catarrh is accompanied by an un- 
usual amount of sneezing, parasite may be suspected. As it increases 
in size there is a sense of fullness, some pain, difficulty in breathing 
through the nostril, impaired sense of smell, and when the growth 
reaches sufficient size, it may disturb swallowing, hearing, and even 
respiration. At times the face is disfigured from the pressure down- 
ward. 

The treatment should be by the application of some mild caustic by 
a camel's hair brush. The tincture of iron and water in equal parts 
is a good remedy when used with the spray instrument and repeated 
daily. If these do not arrest the growth, it should be removed by 
the polypus forceps. 

Ulceration op the Antrum, or Maxillary Abcess. 

Just behind the cheek-bone and above the roof of the mouth is a 
cavity walled on two sides by these bones, and on the third by the 
bone at the side of the nasal cavity. It is empty, and has a small 
opening into the nose. It has a mucous lining continuous with that 
of the nose. This is liable to ulceration in scrofulous people, and 
sometimes has its origin in ulceration of the root of the second molar 
tooth, which touches the cavity, and, in some instances, projects 
into it. 

The symptoms are toothache, pain in the face under the cheek- 
bone, the discharge of matter, attended with great fetor, feverish 
condition and swelling of the face. 

TREATMENT. 

If the second or third molar tooth has not been extracted, it 
should be. The object is to communicate with this cavity through 
the mouth. If a probe does not pass readily in through the 
canal formerly occupied by the root of the tooth, it should be drilled 
for this purpose. When communication is established, the treat- 



404 MEDICAL PRACTICE. 

mcnt is possible, but without, it is impossible. We now have an 
opening at the bottom of this cavity and an opening at the side. 
Injections can be carried upward into the antrum, which will escape 
int » the nasal cavity. After clearing the cavity of its contents and 
cleansing its lining membrane with tepid water, a healing solution 
may be employed, consisting of 

1$. — Glycerine, , one dram, 

Carbolic acid, .... ten drops, 

Tincture of Golden-seal, . . half a dram, 

"Warm water, . . . four ounces. 

Mix and inject. After each treatment the cavity formerly occupied 
by the tooth should be closed by a plug made of soft wood and nicely 
fitted. It should be no longer than to reach to the line of the gums. 
It will be necessary to continue this treatment for several weeks. 
Feverish symptoms may be met on general principles. If pain is se- 
vere, it may be relieved by two-grain doses of opium, taken only at 
bed-time to secure rest. 

Acute Catarrh, Snuffles — Coryza. 

We have partly reviewed this subject under the headings of colds 
and coughs and of catarrh. The principal symptoms of coryza are 
congestion of the mucous membrane of the nasal cavities, frontal head- 
ache, heat in the superior portion of the face, somnolence and dry- 
ness of the mouth and throat. In the more pronounced, the swell- 
ing of the mucous membranes closes the nasal cavities and prevents 
the ingress of air by this passage and compels a constant respiration 
by the mouth. 

It is evident that if we could provoke an energetic contraction of 
the mucous membrane, the air must find a free passage through the 
nasal cavities, the frontal headache and lachrymation di appear and 
with them the dryness of the mouth, which can now be kept closed. 
And more, the expulsion of fluid mucosites that before could not be 
detached by the most violent efforts, are facilitated. 



CORYZA. 405 

This disease, which in adults presents inconveniences only and 
those easily endured, becomes a grave affection when it attacks the 
nursling. Here the closure may menace the life of the infant, in 
rendering impossible its efforts at suction. Prompt action is ne- 
cessary. 

TREATMENT. 

For the adult a snuff may be made of 

1$. — Tannin, six grains, 

Pulverized Gum Arabic, , . . four drams. 

Mix. 
Or of 

3$. — Subnitrate of Bismuth, . , . . three drams, 
Pulv. Gum Arabic, , . , one dram, 

Morphine, . . . . . one grain. 

Mix. 

One-half or the whole of either of these powders may be taken as 
snuff in a da) r , if necessary. The inhalations, in the ordinary man- 
ner from between the thumb and fore-finger, should commence as 
soon as the coryza begins to show itself and be used frequently at 
first. Each time the nostrils are cleared, another pinch should be 
taken. A slight smarting may appear if the internal membrane is 
much irritated, but it soon disappears. 

For children, oil the nose and forehead or smear with glycerine. 
A camel's hair brush should be dipped in glycerine, or ointment and 
then as much of the powd< r as will adhere to the point, taken up. 
This should be inserted in one nostril and repeated in the other. If 
properly done, sneezing soon follows, and the head clears and the 
child will take the breast. Before we learned of this method, we em- 
ployed an ear-syringe, with warm water and tincture of golden seal, 
forcing the fluid up one nostril, to return with the mucus through 
the other. The swelled end of the ear syringe snugly fits the nos- 
tril of infants. 



406 MEDICAL PRACTICE. 

Nosebleed. — Epistaxis. 

When the blood-vessels of the head are weak or congested, rupture 
occurs in the more delicate vessels about the nose and the escaping 
fluid appears at the nostril. If profuse, it may appear at both nostrils. 
Many conditions give rise to nosebleed but more particularly such 
as cause a determination of blood to the head or a plethoric fullness 
of the blood-vessels of the whole body. These are colds, over-heat- 
ing, over-work, over-eating, the use of alcoholic liquors or tobacco, 
suppressed menstruation, pregnancy, injuries, etc. Debility and 
fevers have nosebleed as a symptom; also wounds and injuries, tight 
corsets or collars. 

TREATMENT. 

Remove the cause when known. Remain quiet with head elevated. 
Do not stoop ovi-r but keep the head up and place cloths under the 
nose to catch the blood. Stuff cotton or soft paper under the upper 
lip and tie a cord pres>ing beneath the nose and over the ears, tightly 
behind the head. Any of the following methods may be adopted: 
Burn a cork and powder it in a cup, snuff up pinches of this. Use 
tannin in the same way. Either of these may be blown into the 
nostril through a quill. Soak the feet in hot water, drink hot tea or 
hot water, and apply a cold pack to the nape of the neck. This restores 
circulation and relieves the head. The remedy is oil of fleabane. Rub 
upon the palm of the hand and smell by strong inhalations. Inter- 
nally may be taken 

I?.— Tincture of Fleabane, 

Tincture of Cinnamon, . . in equal parts. 

Mix. 
Take a few drops upon a lump of sugar every quarter or half- 
hour. 



LOCAL DISEASES. 407 



ORDER V. DISEASES OF THE MOUTH, 
FA UCES AND (E SOP HA a US. 

Canker, Thrush, Nursing Sore Mouth. — ApJUhm, Stomatitis. 

This occurs principally in nursing children. The glands of the 
mouth inflame and throw off whitish curdy flakes or scabs. At first 
they are not very numerous, but soon multiply and run together, cov- 
ering the cheeks, gums, tongue, and may extend down the throat 
and digestive canal, affecting the whole tract. The mouth is dry and 
hot, the child feveri h and restless. A greenish-diarrhcea sets in with 
vomiting and the flesh and strength diminish. Aphthous mouth ap- 
pears occasionally in adults suffering from dyspepsia. 

TREATMENT. 

Indigestion is the primary cause of this mnlady and attention 
should promptly be called to the condition of the mother, if nursing, 
or the character and quality of the food taken. For the diarrhoea, 
give the third of a teaspoonful < f calcined magnesia in a little sweetened 
water, or occasional dos> s cf tea made by steeping a teaspoonful of 

I£. — Peppermint leaves, .... one dram, 
Rhubarb pulverized, .... two drams, 
Bicarbonate of Soda, .... one dram. 

Mix. 
In a cupful of boiling water. Sweeten and strain, or let cool and 
settle. For the mouth dissolve a dram of borax in a cup of warm 
water and brush the mouth every three hours with a soft swab made 
of old cotton cloth tied to a stick. A harsh rough swab does more 
harm than good. In adults the patches may be touched by a camel's 



408 MEDICAL PRACTICE. 

hair brush with the tincture of chloride of iron. Another recipe, 
good in all cases, is to take oak and hickory ashes, recently burned, 
and steep in boiling water for twenty-four hours. Strain or filter 
through paper. Dissolve in one pint, one pound of pure maple sugar 
by bringing to a boil. Cool and add one pint of Holland gin. Use 
as a gargle or with a swab. Do not swallow in gargling. As a dose 
ten or twenty drops may be given in water. 



DISEASES AND CARE OF THE TEETH. 



Spongy Gums, Loose Teeth and Disagreeable Breath Caused 
by these Conditions. 

The relaxed and flabby state of the gums is seldom a disease of 
itself. The causes should be searched for among diseases affecting 
the stomach, or among constitutional affections. It may be safely 
asserted that the greater numbe/ arise from constitutional scrofula 
and from dyspeptic conditions In former years it was more com- 
mon to find the malady dependent upon salivation by mercurials. 
Lead also tends to disease and soften the gums. In lead-poisoning 
the gums have a bluish to blackish color. 

Disease of the alveoli, or bony portion of the jaw surrounding the 
roots of the teeth, is more hidden, but also affects the breath (we are 
not speaking of catarrhal conditions). Suspicions of this complaint 
may be held if the teeth are loose; the teeth of course will be firm 
when the necrosis or death of the bo*ne begins. 

The treatment that will harden the gums will also act kindly upon 
the mucous membrane of the mouth and upon any vitiated secretions 
that may be present as a complication. A good plan is rinsing the 
mouth with a solution of ten grains of borax and ten or fifteen drops 



OFFENSIVE BREATH. 409 

of tincture of Hydrastis or tincture myrrh in one third of a tumblerful 
of water. While the solution is in the mouth, the gums may be 
gently rubbed with the ringer end. A brush, however soft, is harsh 
to spongy gums and causes irritation and bleeding. A better wash 
may be compounded as follows : 

I£. — Tinct. of Myrrh, .... two drams. 

Spirits of Camphor, .... one dram, 
Tinct. of Bark, . ... . . two drams, 

Spts. Cologne, one ounce. 

Mix. 

Put a little carbonate of soda in a wine-glass and add a teaspoonful 
of this mixture. With this the mouth may be rinsed and as the 
gums harden it may be use 1 with a brush. It is an excellent wash 
to use after medicines such as tincture of iron, etc., as it destroys th'j 
taste and odor, perfumes the breath and is healing. 

When fetid breath proceeds from decayed teeth; filling or extracting 
them will effect its instantaneous disappearance. If its origin is in 
the stomach, calcined magnesia taken internally two or three times a 
day for a number of days will neutralize and cure it. When the 
odor is very strong or due to catarrh, or does not yield to the above, 
the atomizer must be used as recommended in catarrh. 

When a child while cutting teeth is feverish, restless and can- 
not sleep, a night-cap made of thick material, may ba wrung 
out of cold water and placed on the hot head. Over this a second 
cloth may be applied. This second one can be removed from lime 
to time and reapplied without disturbing the cap. When the gums 
bleed easily and are spongy, the mouth should be thoroughly rinsed 
with a solution of twenty drops of tincture of myrrh in half a gla s 
of water. Gargling the throat at the same time is beneficial to t:;e 
mucous membranes of the throat, tonsils and palate. The addition 
of a small quantity of borax or bicarbonate of soda, will improve 
the wash. If the gums are very tender, simple washing must do. * 
As they become hardened, the end of the finger may be used in rub- 
18 



410 MEDICAL PRACTICE. 

bing the gums while the wash is in the mouth, and eventually the 
brush employed without injury. 

Defective teeth in children indicate d« fective nutrition, particularly 
of the nutrition cf that material of which the teeth is composed. 
These ore plentiful, in unbolted wheat-meal, ratm al, in peas and 
the like. We prepare a syrup containing the exact chemical constit- 
uents, and supply it when wanted at cost, or the prescription will be 
sent upon receipt of application and postagestamp. We ca lit "teeth- 
ing syrup," and it better deserves the name than the many prepara- 
tions assuming this name, which contain chiefly opium or anodynes. 

We have a hint to give those who do not care to lauce the gums of 
children, and it is this : in most cases it will do as well, and as com- 
pletely allay irritation and congestion, to open the engorged blood 
vessels at the reflected junction of the lip and gums. 

Toothache. 

This arises from exposure of the nerves of the teeth, from pressure 
upon the nerve, and from ulceration at the root, which also induct! 
pressure. When the tooth is hollow and the nerve exposed, the cav- 
ity should be closed by cotton or wax. The cotton may be wet with 
the followiug mixture, which we believe to be " toothache drops " 
without a rival. It benumbs and narcotizes : 

^- — Tine. urc of Aconite root, . . one ounce 
Tincture of Opium, ... one ounce, 
Carbolic acid, .... one dram. 

Mix. 
A toothache from other causes than the exposure of the nerve and 
neuralgia, can be better understood from a moment's consideration 
of the anatomy of the parts. Into each tooth-root passes a nerve and 
blood vessels. If, from any cause, the blood-vessels become dis- 
tended with an unusual amount of blood, the bone, being inelastic, 
of course, cannot give way, and the result is pressure upon the nerve. 
This is the actual condition with the majority, and the nerve irrita- 



TOOTHACHE. 411 

tion only increases the trouble. It -will appear, therefore, theoret- 
ically, at leaSt, that whatever calls the blood away from the part 
would relieve the irritation and pain. Practice proves the correct- 
ness of these views. We must cure by counter-irritation. To an em- 
inent and practical physician in this city we are indebted for the 
remedy about to be described. It has these special advantages : it 
is novel simple, within easy reach, and, best of all, effective. 

Treatment. — With a piece of cotton cloth make a small bag about 
the size of a finger-stall, which will snugly cover one-half of the 
little finger. Place in this one-half or one-third of a teaspoonful of 
dry mustard-flour and sew up the opening. This is to be placed by 
the side of the aching tooth, between the gum and cheek, and there 
held. It maybe removed occasionally to prevent blistering. A case 
might occur in which a mustard paste to the outside of the cheek or 
jaw would be advisable, but we have not thus far met such. 

Gumbr/ils may be opened with the point of a pen-knife blade, and 
the myrrh wash used as above described. 

Decaying Teeth. — Dental Caries. 

The general prevalence of dental caries is chiefly owing to food 
remaining on and between the teeth after meals — from breakfast till 
the following morning— when, according to the custom, the teeth 
are brushed, but probably not cleaned, as- the brush is more often 
used to polish the surface merely than to assist in removing what 
las accumul-ited between them. Experiments have been referred to 
that prove the solvent action of weak acids on the teeth; and we think 
it will b" conceded without proof that, were portions of our ordin- 
ary food, mixed and moistened as in mastication, kept during the 
night at the high temperature of the mouth, the compound would 1 e 
sour, li follows that dental caries must continue to prevail as now, 
while the food is allowed to remain in contact with the teeth all 
night. 

When the teeth are wide apart, food does not remain in contact 



412 MEDICAL PRACTICE. 

with them, and they a»e generally free from caries. The 1 »wer front 
teeth are seldom attacked by caries when, as is generally the e.se, 
the spaces Let ween aro closed to the entrance of food by tartar. The 
bucks of all the teeth, upper and lower, bi ing kept free from food 
by the tongue, are seldom attacked by caries. Lodgment of food 
takes place between the bicuspids, between the molars, in the depres- 
sions on the mastic iting surfaces of these teeth, and on the buccal 
walls of these molars, and these are the chief seats of caries. While 
mastication is performed by the molars and bicuspids, the upper 
front teeth remain free from food and from caries; but, when they 
themselves are made to do the work of lost or diseased molars, and 
the food gets between them, caries is certain to follow before long. 
If no food remained in contact with the teeth after eating, they 
would be free from caries, unless acted on by acidity from other 
sources. The only indications, therefore, for the prevention of 
dental caries are the neutralization of acid applied to the teeth, and 
the removal of food before it has b.-come acid. Therefore always 
dean the teeth at night, just before retiring. Scrub the teeth with a 
hard brush, using little, if any, soap; sprinkle on a very little pul- 
verized borax. Until the gums are hardened, and become accus- 
tomed to the use of borax, rinse the mouth often with borax water: 
it prevents it from becoming sore or tender. If artificial teeth are 
worn, cleanse them thoroughly with borax, and when convenient, 
let them remain in borax water ail night; it will purify them and 
help to sv\eeten the 1 reath. 

The brush must be aided by the quill There are points in per- 
haps every mouth, where solutions of food, or other acidulated 
m -tiers cannot be distributed by the brush. The quill breaks up 
these nests on proximal surfaces. The use of brush and quill is not 
a burden ; it becomes a matter of comfort, and one does not feel well 
without them. 
The Odonto-raphic Society promulgates these excellent rules : 
1. Clean,e your teeth once, or oftener, evay day. Always cleanse 






PRESERVATION OF THE TEETH. 413 

them before retiring at night. Always pick the teeth and rinse the 
mouth after eating. 

2. Cleansing the teeth consists in thoroughly removing every par- 
ticle of foreign substance from around the teeth and gums. 

3. To cleanse, use well-made brushes; soft quill or wood toothpicks; 
an antacid styptic toothwash, and precipitated chalk. If these means 
fail, apply to a reliable dentist. 

4. Always roll the brush up and down lengthwise of the teeth, by 
which means you mny avoid injuring the gums and necks of the 
teeth, aud more thoroughly cleanse between them. 

5. Never use a dentrifice containing acid, alkali, charcoal, soap, 
salt, or any gritty or powerful detersive substance. 

6. Powders and pastes generally are objectionable. They injure the 
gums and soft parts of the teeth, and greatly assist in forming tartar. 
A wash, properly medicated and. carefully prepared, is pleasanter 
and more beneficial. It dissolves the injurious secretions and de- 
posits, and the whole is readily removed with the brush and water. 

7. Avoid eating hot food. Thoroughly masticate and insalivate the 
food before swallowing it. Frequent indulgence in sweetmeats, etc., 
between regular meals, disturbs the process of digestion, and a viscid 
secretion is deposited in the mouth (from the stomach) which is very 
injurious to the teeth. 

8. Parents, carefully attend to your childrens' second dentition. 
Gently prevail upon them at an early age to visit, at frequent inter- 
vals, a careful and skillful operator. 

Remember that four of the double teeth come in at the age of six 
years. They are very liable to decay early, are very large, and 
should never be allowed to require extracting. 

Children do not " shed " their teeth as they did in former ages. In- 
stead of being trained to masticate nutritious food, they are tempted 
with and allowed to "gulp down" delicacies, hot cakes, hot bever- 
ages, etc. Thus, by depriving the teeth of their natural function and 
overtasking the stomach, a morbid condition of the general system 
is produced ; the first teeth are prematurely decayed, and the per- 



114 MEDICAL PRACTICE. 

toanent Bet are not mitured at the proper period of dentition. The 
cousequences are terrible. 

9. Never allow any one to crtraH a tooth or to dissuade yon from 
having it filled, unless absolutely necessary. Many so-called dentists, 
actuated by selfish motives, advise extracting, and sacrifice teeth, 
which competent operators, can render serviceable for many years. 

10. Carelessness and procrastination are responsible for a large ma- 
jority of the leeth tint are lost. 

Bleeding from tooth-drawing is insignificant ; only exceptionally 
is it excessive. It may he stopped by placing in the cavity left by 
the tooth a piece of moist cotton dipped in powdered alum, or cinna- 
mon, or in tannin. If neither of these do, use persulphate of iron, 
in powder or solution. 

Dentition. 

The period of teething in infancy is generally looked upon by 
parents with many forebodings of ill. The opinion prevails that 
diseases of some kind, dangerous in character must necessarily ac- 
company the process The fact that it is the growth of a part of the 
body as natural in its development as any other, and certainly not 
involving any vital part, is overlooked. It may be that these beliefs 
are founded upon a sort of deluded and inaccurate experience, and, 
like all fears, i hey are easily circulated. It cannot be denied that 
many children die of cholera infantum, marasmus, and similar dis- 
eases while te-thing. The careful investigation of very many cases 
has compelled the professional opinion that in the majoritj', the indi- 
viduals would have perished of the disease independently of the local 
irritation. With scrofulous and otherwise deficient constitutions in 
parents, it cannot reasonably be expected that it child will develop in 
due and fair proportions, if, ind ed, it d velop at all. We believe 
that we are correct in the judgment, that the diseases co-existent with 
dentition and which hazard if not destroy life, arc those of non-nutri- 
tion. Constitutionally infirm at birth, and, in some instances, pre- 



DENTITION. 415 

maturely born, there is not time during the first six months or eight 
months of existence to bring the system to its proper standard in 
every particular, and thus prepared, have the formation and eruption 
of the teeth a simple continuance of development. In such instances 
the lack of nourishment continues after birth, for if the mother 
furnishes lacteal fluid, it is "thin and watery. ' The proportion of 
nutritive elements is sadly decreased, or if the infant is furnished 
with cow's milk, the stomach is deficient in that vital energy neces- 
sary to proper digestion and assimilation. We do not mean to assert 
or imply but that there are cases in which, from the irritation and 
inflammation attending the appearance of a tooth or teeth, a diseased 
condition is caused and does exist. Every physician and every 
mother of a large family has seen such. Physiologically, ihe advance 
of the teeth should correspond exactly with the absorption of the 
gum. It can readily be conceived that influences may be exerted or 
circumstances arise which would interfere with this co-operative 
action. Then help might be given which would assist the natural 
process. It sometimes happens that this irritation extends from the 
teeth along the jaws, down the throat and stomach to the bowels; 
sometimes it is reflected through the nervous system to the brain and 
spinal column. In the former case, diarrhoea, cholera infantum and 
the like succeed. In the latter convulsions supervene. The use of 
the gum-lance has, in many cases, terminated all these terrible con- 
sequences. This we have seen repeatedly. We are aware that among 
the medical profession, and by those who are cited as authority, the 
fact of such a disease as teething is doubted. Others of equal celebrity 
contend that teething is a disea-e and very prevalent: their lance is 
doing continual duty. The middle ground between these extremes is 
the most favorable and most tenable for both doctor and patient. In 
cases of convulsions, as indicated above, relief has been obtained by 
surgical interference. Another fact which we know to be true, and 
which an extensive experience has corroborated, is, that these convul- 
sions, these diarrhoeas, this restlessness and sleeplessness, this wor- 
rying and rapid losing of flesh can only be stopped by first and direct 



416 MEDICAL PRACTICE. 

attention to the teeth. Our teething syrup contains no soothing or 
narcotic principle, but only the chemical elements which go to make 
teeth, as lime, magnesia, iron, etc. By the vital powers of the sys- 
tem this is transferred from the inorganic to the organic substance 
It is indicated where there is no breadth of gums, with pale counte- 
nance, flaccid muscles, heated skin and disordered bowels. Givinn- to 
such cases the teething material is supplying a deficiency in the food 
and furnishing it in the best pos ible form for absorption and assimi- 
lation.* A word might be said upon the correct method of 

Lancing the Gums. A common method is to push the blade of a 
gum lance or of a penknife down to the tooth, slitting the gum its 
full width at the site of the tooth. The objection to this method is 
that if the knife is moderately sharp, only temporary relief is af- 
forded, because the edges of the wound are smooth and separated 
but little, if at nil. This close proximity favors immediate healing 
Besides, the healing causes a scar, which, as trifling as it may be 
adds further to the resistance to the crown or point of the tooth 

If you must lance, pray do it scientifically. The best plan we 
know of, and a simple one it is, is, instead of making one incision, 
make two, and these at right angles with each other. These may be 
represent d by the letter X, the point of intersection coming as near 
to the centre of the crown as possible. We have here a wound that 
W!ll not heal, the little corners in the centre either curling away from 
the tooth, or shrinking away from the centre, in either case leaving 
a permanent opening. Occasionally we meet with a gum that is ex- 
ceedingly tough, hard and unyielding. In such an instance it may 
be advisable to take out one of the corners entire: thus, X 

All the disorders occurring at this period of life should be treated 
independently of the irritation in the jaw, and as indicated under 
their proper head in this work. This, and the supply of the proper 
material for making teeth, will, in a majority of cases, be all-suffi- 
cient. But, rather than have the little one suffer with convulsion. 



• This prescription gent free upon receiot of letter-stamp to pay postage. 



DROPPED UVULA. 417 

or with any ailment for a length of time, we must advise, as an ad- 
ditional aid and relief, the lancing of the gums. 

Inflamed or Elongated Uvula. 

With all inflammations of the throat, the soft palate and uvula 
sympathize and seldom escape injury. The uvula needs special 
'mention, for it becomes relaxed or elongated, and may remain 
so. In such a case the person is harrassed with a tickling in 
the throat, produced by this organ coming in contact with the back 
of the tongue. The coughing is noticed more particularly at night, 
and many a person— and doctor, too, for that matter— has been 
alarmed at the approach of consumption, when attention to this little 
tormentor would have allayed all fears and resulted in cure in a 
few days. 

The cough is a peculiar one, and, however severe, does not relieve 
the throat. No phlegm is expectorated at first, but may follow after 
a time; being a result of irritation caused by the cough. Upon in- 
spection, the uvula will be found touching the back of the tonszup, or 
a portion lying upon it. In all coughs the throat should be exaii ined 
with this object in view. 

TREATMENT. 

When the dropping first occurs, contraction may be produced by 
gargling the Ihroat with a solution of cayenne. If this does not suc- 
ceed after a few trials, use a solution of tannin, and gargle the throat 
every two hours for four or five days. AVhcn it can be done, a good 
plan is to seat the patient upon your knse, and holdit g the tongue 
down with your finger, pass a teaspoon half full of the tannin solu- 
tion into the back part of the mouth, allowing the uvula to lay in it. 
We have never experienced a failure by this treatment. Still, we be- 
lieve there are cases requiring surgical care. The end is then clipped 
off witli a peculiar shaped scissors, which is so made as to bring away 
the separated piece, and prevent an injury to the throat or mouth. 
Persons should partake of a hearty meal before the operation, 
because it may be necessary to fast for thirty-six hours. 
18* 



418 MEDICAL PRACTICE. 

Phabyngitis. 

An inflammation of the pharynx is likely to occur upon inflamma- 
tion of any of the organs of the fauces, on account of the continuity of 
the mucous membrane which covers them all. An acute attack lim- 
ited to Ihc part under considt ration is rare. If it does occur, the effects 
may not be distressing enough to require special treatment. There 
is an uneasy feeling in the throat but no coughing or difficulty in 
breathing or swallowing. When it extends so as to involve the other 
organs, then we have special symptoms which indicate this change. 
What is known as clergymen's sore throat-, a difficulty to which public 
speakers are liable, has its origin in this membrane and is an inflam- 
matory action taking place in the mucous glands or follicles. These 
arc swollen, and t' e raised points can easily be seen by looking 
through the mouth when the tongue is depressed. Hoarseness is 
almost always present. The treatment is the same as for acute 
pharyngitis. 

Chronic pharyngitis is exceedingly common. Upon examination, 
in nine persons out of ten the membrane will present an unhealthy 
appearance. It is relaxed and has not a uniform color and exudts 
more or less vitiated mucus. When epizo .ty prevails among animals, 
those caring for them may become affected, in which case the phar- 
ynx b comes highly inflamed and discharges an excessive amount 
of corrupt secretion. But as before implied, the affection seldom 
remains confined to the limits of this part of the throat. The chronic 
disorder is accompanied with thickening and morbid secretions. 
These processes will be noticed slowly progressing upward either 
through the eustachian tube, involving it and the inner ear and pro- 
ducing partial or complete deafness, or upward into the nasal cavity, 
causing sub acute or chronic catarrh. With equal facility this 
chronic catarrhal condiion may tend to develop downward, involv- 
ing the air passages, affecting the vocal cords and the voice, become 
se ited in the br nehial tubes, giving rise to bronchitis, or establish 
itself in the air-cells of the lungs, developing consumption. In its 



MUMPS. 419 

downward journey it may leave the larynx intact, involving the 
oesophagus and stomach, presenting that form of dyspepsia known 
as gastric catarrh. 

TREATMENT. 

As a local disease the best local treatment is the application with a 
swab or probang of a solution of burnt alum and sweet oil, in the 
proportion of all the latter will dissolve of the former. The sassafras 
liniment may be applied to the neck, as in tonsilitis. The pharynx 
catches a good share of dust inhaled through the nose or mouth — par- 
ticularly is the latter the target for tobacco smoke and the chute for 
snuff, and it seems almost unnecessary to remark that these irritants 
should be avoided. As the chronic form is in most instances a symp- 
tom of. a scrofulous diathesis or blood condition, constitutional 
treatment is indicated in order that this fluid may be purified: the 
different organs .should receive proper attention in order that its 
purity may be preserved. 

Mumps. — Parotitis. 

This is a tumefaction and inflammation of the paroted gland, situ- 
ated just under the ear. This gland secretes saliva, which is carried 
by a minute canal to about the centre of the cheek and emptied into 
the mouth. One gland or both may be affected. There is heat, red- 
ness, swelling and pain. The jaws become stiff, chewing is painful 
and swallowing difficult. It lasts about a week and occurs of tener 
in children. The disease has one peculiarity; it may change loca- 
tion. From exposure or other cause it may locate in the breasts of 
the female or in the testicles of the male. 

TREATMENT. 

Keep the person from exposure and give cilcined magnesia a tea- 
spoonful in sweetened water, if the bowels are constipated. If the 
patient has a cold or is feverish use the spirit- vapor bath. Internally 
may be given muriate of ammonia in ten or fifteen grain doses every 
three hours, or 



420 MEDICAL PRACTICE. 

fy — Tincture of Gelseminura, . . . two drams, 
Essence of Wintergreen, . . . one dram, 
"Water or Simple Syrup, , . . four ounces. 

Mix. 
Take a teaspoonful every three hours. If metastasis to the testi- 
cle occurs treat the same as Orchitis. 

Inflammation op the Tonsils, Quinsy. — Tomilitis. 

As the name implies, this is an acute inflammation of the glands 
above the roots of the tongue and on either side of the throat. But 
one is usually affected; both may be and sometimes are. There is 
pain and swelling, both increasing in severity as the disease advances. 
Sometimes the pain will dart upward toward the ear or forward 
along the jaw. As the swelling increases, swallowing becomes 
more difficult and occasionally respiration is impeded. The person 
becomes feverish and complains of headache. If the swelling is so 
great as to interfere with the circulation of blood to and from the 
head, the acbing is more severe. Laier, pronounced throbbing is. 
perceived, due to the presence of pus, which points inward. If to 
the front, a white spot is easily seen. Coughing may be present. On 
attempting to swallow anything, a spasmodic action of the tbroat 
repels it. The inflammation may spread and involve the uvula and 
soft palate. The tongue is coated, the secretions of the mouth tena- 
cious and the breath fetid. 

It is distinguished from diphtheria by the tonsil increasing in size to 
a greater extent, and by the false membrane of diphtheria spreading 
in all directions, while in tonsilitis only the white spot or spots whicli 
locate the point of exit to the containing fluid are observed and 
these are stationary and do not spread. 

The indications are to relieve the inflammation and, if possible, pre- 
vent the formation of pus ; if matter does form, to relieve the gland. 

TREATMENT. 

For those who have periodic attacks of this character, and who are, 
therefore, able to anticipate it, active medication may thwart its cul- 



QUINSY. 421 

urination in abcess. These are the employment of a thorough 
catharsis, counter-irritation upon the neck, by the liniment soon to 
be mentioned, steaming the throat, by inhaling the vapor arising 
from boiling hop tea, and by gargling with a strong solution of tan- 
nin. Others may not be as fortunate, for the disease is generally well 
progressed before its real character is discovered. It is caused by 
taking cold, and the Turkish bath will not only relieve this, but any 
soreness or uneasiness noticed in the throat. 

Bind around the neck one or two thicknesses of flannel. Insert 
into this, on the affected side, a folded piece of three or four, thick- 
nesses which has been saturated with the following liniment ; 
1$. — Oil of Sassafras, . , , one ounce, 
Olive oil, , one ounce, 

Spirits of Hartshorn, . , one ounce, 
Camphor gum, . . . one-half ounce. 

Mix. 
This irritates the surface, producing a flow of blood away from the 
inflamed gland. Gargle the throat with : tannin, one dram ; water, 
eight ounces, every hour, or oftener, if preferred. If the feverish 
symptoms are considerable, give 

1$. — Veratrum Viride, . . . thirty drops, 
Tinct. of Wintergreen, . . ten drops, 

Water, two ounces. 

Mix. 
Teaspoonful every two hours. 

If the bowels are costive, administer a cathartic. If the throat is 
very painful, it may be soothed by the hop tea, as suggested above. 
The lood should be fluid, taken warm, and given in a bowl, so that 
the swallowing may continue without interruption until the whole 
meal is finished ; for it is only the first or second effort that hurts. 

If suppuration takes place and throbbing is observed, look for the 
point or head. If it is discovered, and a proper instrument cannot 
be obtained, wind twine around the blade of a penknife to within a 
quarter >;f an inch of the point, and, holding the tongue down with 



422 MEDICAL PRACTICE. 

the finger, puncture the abscess. If it discharges, the relief is re- 
markable and immediate. We dislike the use of the lance. We be- 
lieve ihe tonsil makes a better and more permanent recoverj r if al- 
lowed to open and discharge of its own accord, which usually occurs 
at the time of coughing. 

In persons of a scrofulous diathesis not only is the disease likely to 
recur, but considerable enlargement of the gland remains. The treat- 
ment then becomes more of a constitutional than of a local nature. 
This is presented at length under the head of scrofula to which the 
leader is referred. 

Choking. 

When a fish-bone lodges in the throat, or, in the case of children, 
p.s sometimes happens, a pin or needle, a smart blow or hand slap 
upon the back may dislodge it. In adults great efforts should be 
made to stop every inclination to swallow, and by coughing or placing 
the head low and making an effort to vomit, the substance may be 
dislodged. If this is not effectual, remove it with a common spring 
forcep or a pair of pincers, being careful not to include any flesh in 
the teeth of the instrument. Needles can be removed with' a load- 




stone. If no such instruments are at hand the thumb and finger 
must be used. Whatever is done must be done quickly. 

At times a large piece of meat may, in the act of swallowing, be- 
come fixed in the throat. If this presses upon the top of the air- 
. suffocation will soon follow; time is precious and lives have 
been lu-t in the fruitless attempt to secure the bolus and extract it. 
Immediately seize a fork or spoon and with the handle try to push 
the meat downward and backward; downward at least, if you 



SNORING. 423 

cannot get the proper purchase. A removal of half an inch will free 
the air-passage, and, to a great extent, the imminent danger. Suffi- 
cient time is now given to complete the relief. 

Occasionally it will pass completely beyond the air- passage but fail 
to descend the oesophagus or lood passage. 

All effort at swallowing is abortive. Fluids will return to the 
mouth or more generally find exit through the nose. There is little 
pain and but slight discomfort; still the countenance assumes an ex- 
pression of great fear and impending danger. Relief can only be 
had by continuing the pressure upon the mass until it lodges in the 
stomach. Cover the blunt and smooth end of a piece of round 
whalebone or stout wire, well oiled, with two or three thicknesses of 
cotton cloth, and firmly secure with cord. This will prevent clip- 
ping. Having commenced the pressure, continue to apply it (the 
head being well turned back upon the spine) until it enters the stom- 
ach. This may be known, by success in swallowing water. 

Snoring. 

In introducing this subject we do not mean to imply that it is a 
disease. The party indulging has little knowledge of the event. But 
as it is universally voted by the audience, who unfortunately are usu- 
ally compelled to listen, " as worse than the itch," Me give this subject 
not.ce. The mechanics involved are simple. Like the reed upon the 
accordeon, the uvula hangs from one side, in a narrow passage-way 
through which air is passing to and fro. This causes a vibration, 
and vibration is sound. The conditions necessary are complete relax- 
ation, so that the jaw drops, and profound sleep; like that following 
severe labor. These conditions are not necessary, however, when 
breathing through the mouth has become a h bit. When the air 
passes through the nostrils and pharynx into the lungs, it passes 
down behind the uvula without disturbing it. Hence it will be seen j 
that if the mouth is closed, snoring is impossible. To prevent this 
a night cap should be worn having a tab passing down the face in 



424 MEDICAL PRACTICE. 

front of the ears, which will button or tie with tapes, thereby inca- 
pacitating the wearer from opening the jaws. 



Diphtheria. 

This disease may have been in existence for a great length of 
time, but only during the past decade has it been separated from 
diseases of a similar nature, and classified as a distinct affection. 
The disease may appear in an isolated case, may occur as an epidem- 
ic, and is always considered contagious. It closely resembles, in 
the inflammation of the thi oat, tonsils and contiguous parts, membran- 
ous croup; and in the blood-poison, erysipelas or scarlet-fever. The 
person experiences fever or chill or alternate chill and heat, and 
great physical depression. The tongue is coated, breath foul and 
throat sore. In slight cas s the sore throat may constitute the whole 
difficulty. In a short time little whitish spots appear upon the in- 
flamed surface, which spread rapidly, covering the whole mucous 
surface with a tough threa ly m>. mbrane. This is white at first, but 
soon becomes grey and then black, on account of atmospheric action 
and the admixture of blood. In severe attacks it is spread over 
the larynx downward through the air passages, sometimes reaching 
the minute bronchial tubes, and may be generated upon all mucous 
surfaces and canals, even lining the. blood vessels. This w T ould seem 
to indicate that the disease is a constitutional one, and if it is cured by 
local treatment alone, we believe more or less of the remedy must 
have been swallowed or absorbed. Its violence may produce palsy 
of the mouth, tongue and limbs and perhaps occasion loss of voice. 

It is distinguished from membranous croup, by the coughing in the 
latter, sharp and 'croupal;' the change of voice and the paroxysms 
of difficult breathing. From whooping-cough by the fever and false 
membrane which occur only in the former; and the whoop, the cha- 
racteristic sign of the latter. In scarlet fever the throat is sore, but 
there is a scarlet blush and rash and the absence of a membrane. 



DIPHTHERIA. 425 

Tl e indications are, to reduce the fever; destroy the blood-poison; 
detach the membrane and support the strength. 

TREATMENT. 

That recommended for croup is suited to most mild cases; we re- 
fer to the blood-root tea and cider vinegar. This with a nourishing 
' diet will meet all the indications. Our plan is to give two or three 
dr p doses of veratrum in water every hour or two till the pulse 
falls to eighty or seventy. To remove the membrane we employ the 
probang supplied with a sponge or a brush made by tying to a stick 
a piece of linen, the edge of which has been raveled, and with it swab 
out the throat with the following: 

1$. — Pinus Canadensis, one dram, 

Hot Wa'er, ...'... one ounce. 

Mix. 

Dissolve by stirring and use when cold every half-hour. It does 
no harm to swallow it. Around the neck may be placed a flannel 
bandage and the sass tfras liniment applied as directed in the treatment 
of tonsilitis. See page 421. This treatment is specific. 

As a gargle when no better means are at hand the clear juice of a 
lemon or two is advisable. If a drug store is near, chlorate of potash 
can be procured and a strong solution made by pouring on hot water. 
When cooled sufficiently gargle the throat, of if the patient is a child 
use with a swab. 

The mouth should be well cleansed with the chlorate of potash 
solution or with chlorinated 6oda immediately preceding each ad- 
ministration of medicine, food or drink. 

Inflammation of the Gullet. — Oesophagitis, Aphagia. 

The oesophagus is the tube connecting the mouth with the stomach. 
Seldom is there an inflammation of this organ unconnected with ad- 
joining parts. Such, how r ever, follows the introduction of corrosive 
poisons and the lodgement of foreign bodies in the passage. 



426 MEDICAL PRACTICE. 

False teeth are frequently caught and sometimes with fatal results. 
The lining membrane is s ometimes injured by the probang or stomach 
pump. Swallowing hard substances or hot drinks may inflame. 
The pain cannot be located by the patient but is described as being 
inside and somewhere between the breastbone and spine. The treat- 
ment consists of teaspoonful doses of glycerine and fluid food, with 
sli|>pery-eim tea as a drink. 

« Foreign bodies in tJie oesophagus are not so rare. As observed, false 
tee ih often become fastened, usually near the stomach. In case of 
thickening of its walls even food may be stopped. When the canal 
is partly closed, fluids will pass with pain and difficulty, but when 
the closure is complete swallowing is impossible. Cancer of the 
stomach, about the end of the oesophagus, causes stricture and even- 
tually closure. Foreign bodies maybe dislodged by full draughts ol 
elm-tea. If they pass into the stomach keep on giving the tea and 
administer a cathartic. If the drink has no effect, give an emetic, or 
with the head dependent, tickle the fauces until emesis results. In 
dangerous cases the surgeon employs tongs shaped for the purpose, 
or a probe with flexible handle and stem long enough to reach into 
the stomach. At the end of the stem is a ball to which a circle of 
bristles is tied with ends directed backward and outward. It is 
readily passed in o the stomach; the reverse motion, it is evident, 
must carry all before it. In case of stricture only fluid food can 
be swallowed. When meat closes a strictnred oesophagus it may 
be digested where it is by pepsin. In complete closure the food must 
be fluid and forced into the rectum. In this way life has been pro- 
longed for months. 

Persons who have taken poisons may be able to swallow but will 
not. Tie their hands behind them, pry open the mouth and pass an 
<'inctic through a catheter into the oesophagus. The catheter will 
answer the same purpose if introduced through the nostril. 

Spasmodic stricture, or temporary inability to swallow, is a symp- 
tom (if some diseases. Among these may be named, flatulence, an- 
gina of the heart, hysteria and spinal irritation. 



LODGMENTS IN THE THROAT. 427 

False teeth, fishbones^ pins, needles, coins, etc., lodged in the 
throat may be removed by pounding upon the upper part of the back 
while bending the body forward. Another way is to open the mouth 
wide in a strong light, grasp the tongue with a napkin and pull well 
forward and use forceps or pinchers. A hook may do to carry it to 
the mouth where it is under control. 



MEDICAL PRACTICE. 



ORDER VI. DISEASES OF THE HEART/ 



Carditif. 

The inflammatory diseases of this organ are divided into Pericar- 
ditis or inflammation of the covering, to Myocarditis or inflammation 
of the muscular substance, and to Endocarditis or inflammation 
of the lining of the heart. 

Pericarditis closely resembles pleurisy both in the pain, tenderness 
on pressure and rapid pulse. It may be followed by adhesion and 
drops}'. The treatment is principally the same as that for pleurisy. 

Myocarditis differs but little from the above and its pressure is 
difficult to detect during life. The substances being continuous with 
the covering and lining, the treatment of the Peri or Endo-carditis 
whichever is more prominent, will meet this condi i n. 

Endocarditis presents an important study and has a critical signifi- 
cance to the sufferer. This disease is most frequently brought about 
by metastasis or change of seat of rheumatism. When rheumatism 
attacks the heart there is great danger to life. It may also have its 
origin in Blight's disease of the kidneys. By placing the ear upon 
the chest and listening to the heart-sounds, a blowing sound or bel- 
lows murmur is often heard. Unless the inflammation is soon ar- 
rested, false growths may arise upon its surface, or the valves of the 
organ become involved. These shreds are products of inflammation 
and sometimes become loosened and are carried along in the blood. 
When of any considerable size they may produce obstruction more 
or less complete causing a disease designated Embolism. Endocar- 
ditis involving the valves of the heart may so alter their structure as- 



HEART DISEASES. 429 

to interfere with their normal action. One result is that upon con- 
traction of the heart to propel the blood forward, a valve only par- 
tially closes, and hence a portion of the circulating fluid is forced 
backward (regurgitated). 

As this condition is usually associated with or caused by rheuma- 
tism it is often that proper treatment for rheumatism will remove 
both the danger of this complication or shorten its duration. In only 
a few ca^es have we met the disease and then only when coming 
from the hands of another physician: never when first called to treat 
a rheumatic fever. In addition to the treatment prescribed for rheu- 
matism, a mustard paste may be applied over the heart and removed 
before blistering, to be re-applied as the surface pales. The chest 
should be covered with flannel and not removed until the heart-symp- 
toms have disappeared. 

A common result of inflammation of the heart is Hypertrophy or 
enlargement and thickening of the organ and is combined with re- 
gurgitation. It may arise from other causes, as dissipation or over- 
exertion. It is a common disorder among aihletes and professional 
rowers, runners, etc. Enlargement from these latter causes is tech- 
nically termed dilatation. 

The treatment consists first and principally in rest and avoidance 
of stimulants. Secondly, in the administration of a heart-regulator 
or a tonic. 

Another result of inflammation of the heart, its lining or its cover- 
ing, is that in which the muscular fibres become altered and their 
place taken by fatty matter. This is ca\]ed fatty degeneration. It is 
a disease of the aged and has no known remedy. The heart is soft 
and flabby and any undue excitement or over exertion may teiminate 
life. When this condition is present the inhalation of chloroform 
is particularly hazardous. 

Angina Pectoris is a heart difficulty attended with severe pain. 
The attack is sudden, with tearing pains in and around the heart, 
sometimes extending along the left arm, with great prostration, pale 
and anxious countenance and a feeling of alarm, as though every 



430 MEDICAL PRACTICE. 

throb would be the la«t. If the person survives the first attack there 
is a probability of its repetition when all the symptoms are likely to 
be intensified. The profession have 1 mg been taught that inhalation 
of nitrite of amyl or of chloroform, is advantageous, but recently it 
has been discovered that angina will readily yield to tincture Cereus 
Bonplandii, given in five to ten drop doses, every hour or two, accord- 
ing to the severity of the attack. Severe pains about the heart when 
not associated with organic diseases, will yield to the same treat- 
ment. 

Palpitation of the Heart accompanies enlargement, but is 
more frequently symptomatic of some disease or derangement that 
has a debilitating effect upon the nervous system. Palpitation is con- 
nected with asthma and with hysteria. 

'In Globus Hystericus, palpitation is the principal symptom, and 
paiients complain of the throbbing and the feeling as if the heart 
was rising into the throat and eh- king them. There is a continual 
effort of swalowing; the throat being dry and husky. It occurs 
principally in females, and in the greater number of cases is depend- 
ent upon some disorder of the reproductive organs. The disease is 
of the nervous type, and when this system is quieted all heart symp- 
toms subside. We seldom find change in the organ itself. We see 
violent throbbing or palpitation of the heart in dyspepsia, particu- 
larly in nervous dyspepsia if combined with distention of the stomach 
by gas or wind. A few drops of peppermint essence in warm water, 
afford immediate relief. 

In debility from wasting diseases, such as consumption and long 
continued fevers, slight exertion brings about difficult breathing and 
heart-throbbing. This, however, is a very mild form of palpitation 
and may be alleviated by rest. In every instance the treatment 
should be wijolly directed toward the special disease causing that 
disturbance. 

Closely allied to disease of the heart is a peculiar disorder of the 
principal artery, the aorta. The coating of the artery becomes weak- 
ened and yields, forming a large sack upon one side. This is known 



FAINTING. 431 

as aortic aneurism. The principal symptoms are the bulging of the 
chest in the heart region ami marked pulsation. It is not easily diag- 
nosed, even by the physician, and as relief is extremely doubtful the 
subject is dismissed without further consideration. 

Blue Disease, Blue Jaundice. — GyaiiopatJiy , Cyanosis. 

The name is given to a condition in which the whole surface is 
colored blue, the shade deepening slowly, and as gradually disap- 
pearing'. The color comes from the blood, which, on account of 
imperfect aeration, or oxygenation, ret ins its blue color. The cause 
is organic deformity in the heart or pulmonary blood vessels. There 
is communication between the right and left side of the heart before 
birth, and this is supposed to close with the first breath. When it 
remains open or is reopened by accident, or when the blood is inter- 
cepted or impeded in its way to the lung, blue disease res ; Its. Sud- 
den change of position, uncommon exertion or exercise, the emo- 
tions, and all causes that increase the activity of the heart or circula- 
tion, occasion an attack. 

TREATMENT. 

It will be u=eless to look to medicine for assistance. At birth much 
can be done by position. Laying the infant upon the right side on a 
slightly inclined plane, the feet being lowest, facilitates the closure and 
normal circulation. Eest and quiet are necessary. Care and atten- 
tion must be unremitting. From some imprudence or accident in 
early life, persons so affected rarely reach mature age. 

Fainting, Swooning. — Syncope. 

This condition differs widely from that below described. Here the 
blood leaves the brain, or is not supplied properly. The person sud- 
denly becomes pale and' falls, losing sensation and the control of the 
muscles. The heart beats feebly, and the breathing appears to be 
suspended or is carried on tardily. It is a symptom of a weak con- 
dition of the nervous system, and finds its cause in whatever tends 



432 MEDICAL PRACTICE. 

to produce this debility. Protract- d fever, great loss of blo-xl in 
labor, or by other means, will sometimes cause alarming fainting. 
The syncope frequently recurs, even during the use of the more 
common restoratives. Some are so constituted that they cannot bear 
the sLht of blood, the smell of disagreeable odors, or any unusual 
surprise, or other source of mental emotion, without fainting. Severe 
pain will sometimes produce faiutness. 

TREATMENT. 

But little else needs to be done than give nature an opportunity to 
restore the circulation of blood. This is best accomplished by laying 
the person down upon the floor, ground, or any level place that is 
near by and convenient. Do not keep a fainting person sitting in a 
chair and expect by vigorous fanning to resuscitate. Place upon the 
back, the first thing, and they will revive in less than half the 
time. A place near a window or door, or in the open air, is prefera- 
ble. Water sprinkled or snapped from the fingers upon the face is 
effective. Harts! lorn or smelling salts applied to the nostrils arouses 
consciousness. Stimulants may be administered as soon as the pa- 
tient is able to swallow ; or 

1$. — Compound Spirits of Lavender, . one ounce, 

Chloroform, one dram. 

Mix. 

Give a teaspoonful in a little water, and again in fifteen minutes, 
if thought necessary. In common cases it will not be needed, but in 
repeated faintings, following loss of blood, every effort must be made 
to sustain the flagging vitality. 

Giddiness, Dizziness. — Vertigo. 

Vertigo is only occasionally caused by diease of the heart : how- 
ever, we will discuss the subject under this order. 

By some the name of "swimming of the head" is given more, we 
fancy, from the swimming of objects in a whirlpool, than any appear- 
ance of the head in contact with the water. All the terms imply motion. 



DIZZINESS. 483 

External objects appear to turn round, or the person feels as if the 
head was rotating. This confusion results from a rush of blood to 
the head ; for a moment the individual is unable to collect himself 
so as to have any consciousness of what is happening around him. He 
feels the sudden attack, and endeavors to reach something to which to 
hold fast until the spell passes : if he fails to catch, or if the attack is un- 
commonly long or severe, he falls to the ground. It is rather a sign 
of disturbed circulation than any dreadful disease, either present or 
to be apprehended. Persons subject to vertigo much dislike to travel, 
and seldom leave the house without an associate. Dizziness may be 
experienced by any one upon suddenly rising from bed, or after 
stooping for some time. Of course, the plethoric or full-blooded are 
more liable. We may expect vertigo to accompany some of the fol- 
lowing diseases : indigestion or dyspepsia, mental and nervous pros- 
tration and exhaustion, congestion of some of the internal organs, 
feeble heart, constipation, and brain disease. 

TREATMENT. 

The disease or condition which causes it must be removed. If 
it results from stooping or bending over, but little attention need be 
paid to it further than to be cautious at another time, and rising up 
slowly. Habit has much to do with our ability to congest the head 
without losing consciousness. Not every one may "gather shells 
up6n the shore." The dyspepsia and constipation will probably 
need magnesia and nux vomica, or other bitters ; the weak heart, 
belladonna and tonics ; the exhausted, rest, phosphorus, strychnine, 
or bromide of ammonia. In all is needed an active circulation, 
such as will dispel local congestion and remove this tendency toward 
the head. Keep the feet warm by gentle exercise or by rubbing, 
dress so as to distribute the heat evenly over the body, avoid all ex- • 
citement or fatigue, and partake of light diet. 

19 



434 



MEDICAL PRACTICE. 



ORDER VII. LUNG DISEASES. 



Colds and Coughs. 



"Colds are caught," is a common expression, but from the fre- 
quency with which they occur and the multitude who possess them, 
we are almost justified in making the assertion that colds are sought. 
If not sought, it is very apparent that but little attention is given to 
the matter of avoiding them. Almost without exception we take 
cold from the sudden lowering of the temperature of the body, 
either in whole or in part. There has been vigorous exercise or labor, 
at least sufficient to bring about sensible perspiration. Up to ibis 
point the function is normal and its effect conducive to health. Ot 
account of clothing the feeling is uncomfortable and a draft of air ot 
shady retreat draws us away for rest and cooling. The rest is proper 
but the perspiration should be evaporated but slowly. 

It is not meant to declare that in every instance the actual motion 
of the air is necessar}' to produce a cold, for it can easily be demon- 
strated that the difficulty lies principally in a considerable but sudden 
change of temperature. The farmer in a hay field rests from his 
labors by reclining upon the damp ground in the shade and falls 
asleep. The parts likely to be chilled are those which touch the 
ground. The merchant, after a hasty walk, lays aside his overcoat 
and sits in a cool office. The friend parting with his companion may 
stand a half hour upon the sidewalk in winter, his feet becoming 
chilled. The driver will sit upon his seat in a drenching rain until 
the chest is chilled. The dancer leaves the waltz and seeks the open 
window. The high temperature of our dwellings and the still higher 



COLDS AND COUGHS. 435 

thermometric indications of the church, theatre, lecture-room, etc. , 
are quit without that care and proper appreciation of the great dif- 
ference which usually demands one or several extra articles of cloth- 
ing. Granted that the skin is not super-sensitive, it is a fact that it 
is almost impossible to take cold while the body is active. The driver 
should leave his seat occasionally and walk or trot at the side of his 
horse. The farmer, the dancer, and others similarly situated, should 
keep up a general motion of the body, such as walking, until the 
surface is cooled. 

A little care here will save much trouble and sickness. Try and 
bear this in mind. When entering an edifice likely to be crowded 
and hence over-heated, remove the shawl or overcoat, which should 
be replaced before going outdoors. If possible, better cool off in the 
same room before leaving. A few minutes time will be sufficient. 
If the overheating arises fr.-m outdoor labor, or even indoor work, do 
not seek a window or draft of air. Warm mufflers worn about the 
neck do not protect you from taking cold, but, on the contrary, r< n^- 
der you extremely liable to take d >ld as soon as you take them off. 
They make the throat tender. Ladies ought to wear warmer flannel 
underclothing than they do, if one may judge from the articles one 
sees hanging in the show windows of the shops. People take cold 
from inhaling cold air through their mouth oftener, perhaps, than 
by any other way. Ladies dress themselves up in heavy furs, go 
riding in their carriages and when they get home, wonder how they 
took that cold. It was by talking in the cold open air, and thus ex- 
posing the mucous membranes of the throat. The best protection 
under such circumstances was to keep the mouth shut. If people 
must keep their mouths open in a chilly atmosphere, they ought to 
wear a filter. Above all, be careful of your feet in cold, damp 
weather. Have thick soles on your shoes, and, if caught out in the 
rain, which lasts so long as to wet through your shoes, despite the 
thick soles, put on dry f tockings as soon as you get home. But in 
cold, wet, slushy weather do not be caught out without overshoes. Rub- 
bers are unhealthy, unless care is taken to remove them as soon as you 



436 MEDICAL PRACTICE. 

get under shelter. They arrest all evaporation through the pores cf 
the leather. Cork soles are a good invention. When you go into 
the house or your office, after being out in the cold, do not. go at once 
and stic •: yourself by the register, but take off your co:it, walk up 
anl down the room a Utile and get warm gradually. Warming your- 
self over a register just before going out in the cold is one of the 
worst things that you can do. 

While mo>t c >lds are. unaccompanied with cough, a cough is not 
always an index of a cold. Any irritation of the windpipe (larynx 
and trachea), will cause a cough. The lodgment of dust upon the air- 
passage has a similar effect. Dyspepsia is often indicated by this 
symptom; so is menstrual derangement; likewise spinal irritation, 
ar.d, as we htve noticed in another place, elongated uvula. This 
Symptom is of value to the j hysician, but to those unlearned inmedi- 
ca 1 science, is has a v ilue only as indicating an organic difficulty. 
The connection between the two is by and through the nervous sys- 
tem; princip-dlv through the sympathetic and pneumogastric nerves. 

All colds effect the system but in one way, namely by contracting 
the skin. The blood is forced from the surface and some internal 
organ congested. The congestion usually takes pHce in the weak- 
est organ, whether it be the throat, the lungs, the kidneys or what 
not. It is noticeable that in addition to uniformly congesting the 
same organ, that with each attack the organ in question is weakened, 
and hence colds are more easily taken. Another point worthy of 
mention is, that at the outset the congestion is very easily removed 
and conversely that it becomes more difficult the longer its duration, 
terminating eventually in active inflammation. Even so serious and 
dangerous a disease as pneumonia is a simple cold at its inception. 
Catarrh, which, once established in our northern latitudes, is likely to 
continue through life, commences in so simple a manner. 

TREATMENT. 

So ready a means as a Turkish bath, or the use of a spirit-bath 
combined with some warm drink such as hot milk, spiced with pep- 



COLDS AND COUGHS. 437 

per, will re-establish perspiration, thus opening the pores and re- 
lieving the internal congestion. 

As the serious diseases to which colds may lead are treated under 
their respective headings, we have a few words only to say, upon 
the methc ds to he adopted where relief is wanted from some annoy- 
ing or distressing symptom. 

Where sneezing is persistent chloroform may he inhaled or opium 
taken by the s'omach, in two grain doses, every two hours until 
relief is afforded. Where a catarrhal discharge is excessive and 
acrid, a teaspnonful of glycerine may he added to a cupful of warm 
water, and a teaspoonful poured into the palm of the hand and 
snuffed up the nostrils. The f< eling of tightness in the forehead is 
relieved by anointing the forehead aud nose with pure glycerine. 
The stuffed up feeling in the nose (diminished smell) is readily re- 
lieved by inhaling (smelling), the vapor of the spirits of camphor 
from the mouth of a bottle containing it. 

The hacking, which hardly amounts to a cough and hoarseness are 
someti i es the precursors of pneumonia. It may however be but a 
trifling affection of tae throat. It is easily relieved by inhalation of 
the vapor of tar, by means of the Pocket Inhaler. (See page 440). 

Our favorite cough syrup has several qualities to recommend it : 
it is simple, pleasant, inexpensive and effective. We do not declare 
it to be the best in the world, but we have yet to meet is rival in 
curing common coughs and colds. Neither have we any intention 
of warranting it to cure consumption, as most cough remedies are 
now-a-days advertised to do. The formula is 

1$. — Tincture of Lobeli i leaves, . . two drains, 
Tincture of Bloodroot, . . one dram, 

Tincture of Tolu, . . two drams, 

Essence of Wintergreen, . . thirty drops, 
Simple Syrup, enough to make . four ounces. 

Mix and take a teaspoon ful every two or three hours. 



438 MEDICAL PRACTICE. 

Inflammation of the Larynx — Laryngitis. 

The apparatus winch modifies the air we breathe so as to produce 
voice, is the larynx. It is situated at ihe front of the neck, its pro- 
jection being familiarly known as Adam's Apple. Within are the 
voc.il cord-, and any disease which would alter the structure of these 
organs would be expected to change the voice, which it does. The 
hoarseness from taking cold denotes a mill form of laryngitis. With 
it we have a tickling sensation or irritation in the windpipe, cough, 
but little expectoration, and some difficulty of swallowing. This ' 
may all subside in a few days if treated as a cold. 

If the inflammation is 
more pronounced, the dif- 
ficulty of breathing be- 
comes more pronounced, 
with wheezing, and voice 
may be lost. The cough 
is distressing and painful, 
fever supervenes, inflam- 
mation is high, and parts 
are tender to the touch. 
It is then dangerous, and 
may result in strangula- 
tion. It is a di>ease of 
adults, and closely resem- 
bles croup in children. 
The young may have 
laryngitis from the lodg- 
ment of a foreign body in 
this organ. 

In chronic laryngitis the 

voice is modified or lost, 

and may remain so from 

change of structure. VI- 

LAitYNaoscopic lantern. ceration and thickening 




LARYNGITIS. 439 

are not uncommon. The cough and exppctoration resemble bronchi- 
tis and consumption. Laryngitis may coexist with consumption in its 
later stages, and is frequently met in advanced syphilis. 

Not all the diseases in which loss of voice occurs are structural. 
For the nervous affections, see under head of Aphonia. 

It is distinguished from tonsilitis or quinsy sore throat, in 
which there is difficulty of swallowing, by the pain being higher 
up, and by the enlarged glands, which can be plainly seen upon 
inspection of the throat. In pharyngitis there is also pain in swal- 
lowing, but there is no alteration of voice. The voice is altered 
in croup, but there is no pain in swallowing. The cough resembles 
that of bronchitis and consumption, but in laryngitis the lungs will be 
found by auscultation to be normal. The condition of the part and 
the presence of ulcers, tumors, etc. , are best ascertained by the use 
of the laryngoscope. This instrument simply consists of a small 
mirror supplied with a long handle. This is placed in the back of 



IiARYNGOSCOPIC MIRROR. 

the throat, and reflected and concentrated light thrown upon it. The 
image of the upper windpipe appears in the mirror, and the part can 
be carefully and thoroughly examined. 

TREATMENT. 

In the acute form it is only necessary to follow the instructions 
given elsewhere for the management of a cold. A wet compress may 
be bound around the neck, and allowed to remain during the night. 
If the hoarseness continues, 

$.— Oil of Tar, . . . . . ten drops, 

Oil of Fleabane, .... five drops. 
Alcohol, . .... four ounce?. 

Mix. 



440 



MEDICAL PRACTICE. 



Drop upon the sponge of a Pocket Inhaler some fifteen or twenty 
drops, and gently inhale for five minutes every two hours. This is a 




POCKET INHALER. 



matter of strong practical interest to singers and speakers who wish 
to clear the voice in the shortest possible time. With an atomizer the 
time taken in affording relief may be greatly shortened. Put twenty 




TOBOLD'S LARYNGOSCOPE, ADJUSTABLE TO A STUDENT'S LAMP, WITH REFLEC- 
TOR FOR CONCENTRATING THE LIGHT UPON THE Mirror IN THE THROAT. 



CROUP; 441 

drops of the above recipe in an ounce of hot water and inhale the 
medicated vapor for five minutes, repeating in a quarter of an hour. 

During this treatment the voice should be tried as little as possible 
and just before public appearance swallow a small portion of capsi- 
cum, or better, allow a cayenne lozenge to dissolve in the mouth as 
a stimulant. 

Chronic Laryngitis, in a majority of cases is catarrhal in character 
and is not confined to the larynx but extends downward along the 
trachea to the bronchi or upward to the pbarynx and nasal cavity. 
Our treatment varies but little from that for catarrh; by medicated 
spray from an atomizer. When the difficulty of breathing is great 
the liquid should be as hot as can be borne. Ulcers, tumors and 
such serious conditions, it is needless to say, require the physician's 
skilL 

Cbotjp. 

Croup is of two kinds, the false and the true. In the former there 
are feverish symptoms and hot skin, flushed face and frequent cough- 
ing, which is hoarse, as noticed usually with a heavy cold, but in 
addition, is accompanied with a loud shrill noise at each inspiration. 
This sound, so peculiar, is the characteristic of the disease. The 
paroxysm comes on without warning, except it may be a slight indis- 
position manifested by restlessness upon retiring ; the child waking 
up suddenly, alarmed and distressed for breath. After a while this 
spasmodic action of the larynx subsides and the child falls asleep. 
The attack may be repeated later in the night or at the same hour 
the ensuing night. In the interim all symptoms of the disease and 
generally of any disease of the throat are wanting. 

True croup is better known as membranous croup. There is some 
spasm, but the principal feature is the amount of inflammation in 
the throat, which inflammation throws off a false membrane. This 
membrane not only covers that part of the throat which can be seen 
but extends downward into the bronchial tubes. The symptoms, 
particularly at the outset, are identical with those of false croup, 
19* 



443 MEDICAL PRACTICE. 

but differing in intensity. The hoarse voice, the difficult breathing, 
the ringing cough, the crowing expiration and high fever are present. 
As the disease advances, appetite is lost, the voice hoarse at first, 
becomes less and less distinct until finally it is destroyed. The cough 
may at times dislodge pieces of the membrane but, unless relief is 
had, *he air passage is closed and the child dies of suffocation. 

This dangerous affection cannot be confounded with false croup 
when it is remembered that the false variety occurs only at night 
and ceases altogether in from two to five or six attacks. The mem- 
branous progresses steadily to its termination; the hoarse voice and 
difficult respiration are always present; paroxysms occur both by 
day and by night and the only sure symptom, false membrane, is 
expectorated. 

It is distinguished, without much difficulty, from diphtheria, which 
it closely resembles, as bo'h diseases are accompanied with false 
membrane and high inflammatory action with fever, thirst, etc. But 
in diphtheria we miss the sharp cough, th<: husky voice and the par- 
oxysm of difficult breathing. In whooping-cough the voice is un- 
changed, there is no fever, no false membrane, and there is the char- 
»cteiistic whoop, absent in croup. 

The indications are to overcome the spasm, to reduce the inflamma- 
tion, and prevent the forniHtion of membrane. 

TREATMENT. 

Whether the dis< a e is the true or false, give five to ten drops of 
tincture of lobelia in swee'ened water, every fifteen or twenty min- 
utes. If the difficulty of breathing is great, the dose may be doubled 
and vomiting provoked. In the false variety, after the vomiting 
ceases, the child sleeps, and it is the last of the disease. If there is 
considerable fever, the membranous varirty may be suspected, and in 
this ca^e broken doses of veratrum, say one-half to one drop every 
hour may be given till the pulse falls to its natural standard. This 
treatment will destroy inflammation and with it the exudation or for- 
mation of this false material. A good treatment where these reme- 
dies are not to be had is to use bloodroot. Take a dram of pulver- 



LOSS GF VOICE. 443 

ized bloodroot and pour upon it half a pint of boiling water. Cover 
closely and allow it to steep for a few minutes, then add half a pint 
of good cider vinegar. Part of this sweetened in sugar may be 
given in teaspoonful doses as often as the child wishes or will receive 
it. It hardly ever sickens or produces vomiting. The acid acts 
chemically upon the membrane; locally while being swallowed, and 
by absorption into the blood after reaching the stomach. In the 
blood it prevents its future formation. The bloodroot reduces the 
circulation, has a tonic effect upon the mucous surface of the air- 
passages, and is an anti-spasmodic. 

Ckowxng Disease, False Ckoup. — Asthma Thymicum, Laryngis- 
mus stridulus. 

This affection occurs generally in infants and generally about the 
teething period. There is a spasmodic closure of the air-passage and 
great difficulty of breathing. In this it resembles the asthma in 
adults. When the breath is inspired it is attended with a loud whist- 
ling or crowing sound, giving it the familiar name of crowing dis- 
ease. The spasms are more noticeable upon waking, crying or swal- 
lowing. The fit of suffocation, or the convulsions following, may 
end life. The disease is comparatively rare, attacks suddenly, lasts 
but a short time, and is seldom fatal. 

Treatment. — The remedies used should be the same as those em- 
ployed in the treatment of spasmodic croup, which it resembles in 
many particulars. 

Loss of Voice. — Aphonia. 

There are several diseases in which the voice is lost. A common 
example is a cold, where hoarseness or roughness of voice follows, 
or it may increase in severity until the only communication possible 
is by a whisper. This is of little consequence and is soon regained. 
In hysterical females the voice is sometimes wanting. An electric 
shock is likely to suddenly recall it. When it occurs from some dis- 
ease of the larynx it is of a more serious nature. There are many 



444 MEDICAL PRACTICE. 

local diseases of this organ but the particular one in question can 
only be definitely determined by the use of the laryngoscope. 
Paralysis may and often does produce aphonia. In this instance it 
is usually relieved by electricity. The voice may be lost by power- 
ful emotions, and is sometimes, strange to say, recovered in a similar 
manner. 

BRONCHITIS. 

This is an inflammation of the lining membrane of the air-tubes 
connecting the throat and lung substance. A "cold on the chest" 
maybe a slight bronchitis; it may be acute and severe, dangerous 
in infancy and advanced age, or chronic, lasting for years and ter- 
minating in consumption. The cold settling in this locality differs 
from others in the deep seated pain and raw feeling, the greater 
amount of couching required to dislodge mucus and the hoarseness. 
The acute disease is more formidable. There are chilly sensations, 
fever, headache, constipation, loss of appetite, thirst, difficult and 
noisy breathing, hoarseness with dry, harsh and painful cough, fol- 
lowed in a few days by mucous expectoration, sometimes streaked 
with blood, and general depression. It sometimes follows scarlet- 
fever. 

The chronic disorder is too frequently the result of a neglected 
cold. Through the summer but little is thought of the slight cough, 
but as soon as the cold weather sets in, the symptoms are aggravated and 
the invalid seeks the physician. It is then discovered that a seated 
catarrh of the bronchial mucous membrane exists. Colds are easily 
and frequently taken and the cough and expectoration increased; the 
strength is failing, the appetite poor, bowels constipated and voice 
changed. When the expectoration is scanty, it is termed dry. It may 
exist for months or it may terminate in consumption. It is a com- 
mon complication of Bright's disease of the kidneys. 

It is dUtinguulied from whooping-cough by the absence of the 
whoop, the difficult breathing between the spells of coughing and 
the fever. In pneumonia the breathing is rapid, in bronchitis diiil- 



BRONCHITIS. 445 

cult and harsh, and in pleurisy feeble, with an effort to limit or con- 
trol the volume of air inspired. Thus much as far as children and 
the acute attacks are concerned. Chronic Bronchitis is more fre- 
quently associated by the people with consumption on account of the 
cough and expectoration. The family history will help us in form- 
ing a correct opinion, the occurrence of hemorrhage and hectic fever 
shed additional light and the dull resonance upon percussing the con- 
sumptive lung discriminate against bronchitis. 

The indications are to diminish fever, reduce the bronchial inflam- 
mation, loosen the cough and expectoration, destroy the tendency to 
take cold and tone up the system. 

TREATMENT. 

Acute attacks may be treated the same as colds, that is by the 
spirit vapor bath, by warm herb teas, a hot pack to the chest or by 
one of these and a cough syrup, such as 

1^.— Tincture of Lobelia leaves, . . . two drams, 

Tincture of Bloodroot, . . . . . one dram, 
Tincture of Tolu, . . ... two drams, 

Simple Syrup, . . . sufficient to make four ounces. 

Mix. 

Tincture of wintergreen, thirty drops, may be added as a flavor. 
A teaspoonful is a dose for an adult and may be repeated every two 
or three hours. This treatment will favorably affect the fever, or 
aconite or veratrum may be used for the same purpose. Much re- 
lief is afforded by annointing the chest with a mixture of quinine, 
one dram, lard (unsalted), one ounce or with the antiseptic ointment. 

In the chronic form we have little fever and but slight inflamma- 
tion. Complaint is chiefly made about the frequent colds taken. 
Our advice is to throw away that muffler about the throat and shoul- 
ders and put its equal weight in leather upon the soles of the boots; 
a cork insole is additional assurance. Frequent foot-baths and a 
chest-bath daily upon rising followed with brisk friction, together 
with daily outdoor exercise, develops a constitution proof against 



446 



MEDICAL PRACTICE. 



colds. To allay the irritation and cough, heal the throat and lungs, 
and induce free respiration and rest, 
I£. — Canada or Fir Balsam, 
Alcohol, 



Pulverized Licorice, 
Tincture Ipecac, 
Tincture Lobelia, 
Tincture Capsicum, 
Simple Syrup, 
Water, 



one-half ounce, 
eight ounces, 
one ounce, 
one-half ounce, 
one-half ounce, 
one dram, 
one pint, 
one pint. 

Mix. 



Dose, a teaspoonful even- two or four hours. 
In place of the above, or in alternation with it every other week, 
may be used a " Cherry Pectoral " without a rival: 

$. — Syrup of Wild Cherry, . . . five ounces, 



, Tincture of Bloodroot, 
Tincture of Black Cohosh, 
Wine of Ipecac, . 
Morphine, 



. one ounce, 
. one ounce, 
. one ounce, 
. four grains. 

Mix. 
Dose, a teaspoonful every two, three or four hours. If it is desired 
to promote expectoration, make twenty pills of the following recipe 
and take one, three or four times a day; 

1$. — Pulverized Ipecac, .... ten grains, 

Pulverized Lobelia, . . . .ten grains, 

Pulverized Capsicum, .... four grains. 

Mix. 

With many, emaciation and loss of strength, are the conspicuous 
symptoms. Under such circumstances we cannot too strongly recom- 
mend the use of the hypophosphates combined with wild cherry and 
cod-liver oil, referred to at length in the essay upon consumption. 
The combination is so formed that the presence of the oil is entirely 
disguised; this drug, as usually prepared, turns the stomachs of 



WHOOPING-COUGH. 447 

the majority. With this compound and the application of nebulized 
liquids by the spray apparatus, most cases can be cured, (see Catarrh:) 
In all diseases of the lungs and ait-passages the most sensible and 
most effective plan of treatment is by direct medication. Bronchi- 
tis, consumption and catarrh, formerly so slow to move, now exhibit 
remarkable changes in a few weeks. To this point the medical pro- 
fession must ultimately come. 

Whooping cough, Hooping-cough, Chin-cough. — Pertussis. 

This is a cough peculiar to infancy and childhood; rarely attacks 
adults. It is considered contagious, but fortunately seldom occurs 
but once. A cough having nothing uncommon at first, is noticed in 
a week or ten days to become more severe and protracted. The child 
appears unable to get breath for a painfully long time. The face is 
bloated and red with blood during the paroxysm, blood-vessels dis- 
tended, eyes prominent. The chiid runs and grasps its i an nt or nurse 
and, after several convulsive expiratory efforts, a deep, peculiar, noisy 
inspiration follows and perhaps a little mucus is raised. This rapid and 
sonorous inspiration is called a whoop and gives the name to the disease. 
These paroxysms, so distressing l)otli to the patient and observer, 
may occur only in the evening, or three or four times daily, if the 
case is a mild one, or when severe, every half-hour or often er. It 
lasts one or two months and gradually wears away. It is seldom dan- 
gerous and only becom< s so when some complication, like pneu- 
monia, sets in. It racks and strains the system severely, and we 
believe may lay the foundation for lung and brain diseases, although 
it may not actually produce them. 

How Wn disease first arises we do not know positively, but we do 
know that it is very readily conveyed and that in a great number of 
cases it is easy to trace the channel through which it has been com- 
municated; hence we must draw an inference unfavorable to the care- j 
le-sness of parents, particularly when the disease is known to be in 
the neighborhood. 



448 MEDICAL PRACTICE. 

Respecting the cause, we are inclined to ngree with Dr. Tschamer, 
of Gratz, who has discovered that a fungus grows upon the skins of 
apples and oranges, precisely similar to the fungus which forms the 
peculiar germs of infection in whooping-cough. He writes that on 
oranges and apples which have been kept some time, may be found 
dark brown and black specks, which, when scraped off, appear as a 
damp powder. Under the microscope this powder is seen to consist 
of the spores of a fungus identical with those of the whooping- 
cough fungus. Taking two of these specks from the skin of an 
orange, Dr. Tschamer introduced them by a strong inhalation into his 
lungs. The next day tickliug of the throat began, which gradually 
increased, until, at the eighth day, a thoroughly developed whooping- 
cough set in. Should the discovery be confirmed, there is an 
additional reason to see that children abstain from eating apples with 
the skin on, and from chewing orange peel, which many are so fond 
of doing. 

It is disting uisJied from croup, scarlet fever, diphtheria and a cold 
chiefly by the ichoop. In whooping-cough the voice is unchanged, 
there is no fever, no fal^e membrane, and no difficulty in breathing 
when not coughing. 

TREATMENT. 

A specific for whooping cough is a strong tea made of chestnut 
leaves and sweetened to taste. From a tablespoonful to half a wine- 
glassful, should be taken three or four times a day. This is a remedy 
little known, but said to cure whooping-cough almost miraculously. 
We have used it some and have been pleased with the results. Our 
experience has been more extensive with the Red Glover plant and 
blossoms. It is cultivated in almost every part of the United States, 
and flowers throughout the summer. In efficacy it has no equal. 
Made into a strong tea and sweetened, it must be given as a drink at 
m- als, and as a remedy between meals and on rising and retiring. 
Compare its effects upon your own with that of a neighbor's chil- 
dren, who are dosing with drugs and " cough mixtures." Yours 
will begin to mend in three or four days and be well a month or two 



ASTHMA. 449 

before the others. It cannot, of course, he used so freely with in- 
fants, but alternating with it a spray of carbolic acid, one drop to 
warm water an ounce, the cough yields readily. 

ASTHMA. 

This disease is so well known and differs so much from other af- 
fections that only a brief description is required. It occurs spasmod- 
ically and daring the interval, the person is almost entirely free 
from any symptcm that would indicate lung disease. Suddenly and 
without warning there is difficulty of breathing accompanied with a 
feeling and corresponding conduct as if suffocation was impending. 
The paroxysm occurs usually at night and no matter how spacious 
the room, or how inclement or cold the weather, the demand is for 
more air and is hardly satisfied if all windows and doors are thrown 
open. The countenance expresses great fear and anxiety and, des- 
pite the struggle for breath, the lungs expand but little. A loud 
wheezing sound continues while the spasm lasts. At its termination 
there is coughing and copious expectoration. An attack may con- 
tinue for a few minutes, a few hours, or even last f ■ r days. 

The condition producing a paroxysm is a spasmodic contraction of 
the bronchial tubes, thereby limiting the supply of air to the lungs. 

The causes in a majority of cases can be traced to disease of some 
other organ or part of the body. Dyspepsia is the most frequent 
and, in the order named, follow disease of the kidneys, of the spinal 
cord, of the brain, of the heart, of the lungs, of the bladder, female 
complaints, irritating vapors such as the fumes of matches, of nox- 
ious gases, dust, sometimes humid atmosphere from an approaching 
storm, etc. The disease is seldom fatal. 

It is distinguished from other diseases by its being paroxysmal and 
accompanied with wiieezing. Oilier diseases of the air passages 
that might bear a resemblance come on slowly or are wanting the 
symptom of wheezing. Croup is attended with hoarseness, cough 
and with a fever ; asthma is not. 



450 MEDICAL PRACTICE. 

TREATMENT. 

'When possible, a change of occupation is advisable. Some have 
recovered in a year or two without medication, by living almost en- 
tirely out-doors. In a few instances a chunge of climate is benefi- 
cial ; the salt air on our seaboards acting as an irritant, the drier air 
of the praries ameliorating the attacks. Cases have recovered by 
following a course of Turkish baths, and by the use of electricity. 
The remedies generally used may relieve the spasm but do not per- 
manently cure. The most common is by inhaling the smoke from 
burning stramonium. It can be prepared by pulverizing the 
leaves when dry by rubbing between the hands.. Remove the 
stems. Stir in some pulverized nitrate of potash (saltpeter), 
and it is ready for use. If preferred in balls or cones it may 
be dampened with water, shaped and dried. Place a cone or 
about one-third of a teaspoonful of the powder upon a shovel, or 
piece of metal or crockery, fire it by a lighted paper a* d inhale the 
fumes. Leaning the body forward cover the head with a cloth that 
will han:: down about a foot to confine the smoke. The coughing 
produced should not be avoided as it secures deeper inspirations. 
Drinking a cup of hot water may do as well. Once we considered a 
good remedy a syrup composed of 

J?. —Tincture of Bloodroot, . . . two drams, 
Tincuie of Lobe'ia, . . . four drams, 
Simple Syrup, to make , . four ounces. Mix. 

Add essence of wintergreen to flavor, if desired. A teaspoonful 
was given every hour or two; if paroxysm severe, every five or ten 
minutes till nausea supervened. 
Now we prefer to either of the above the following: 

1$. — Tincture of Iodine, .... four drams, 
Tincture of Camphor, .... one ounce, 

Oil of Tar, one half dram, 

Carbolic acid solution twenty drops, 

Chloroform or Sulphuric Ether, . . two ounces. 

Mix. 



ASTHMA. 451 

Pour from fifteen to sixty drops upon the sponge of the Pocket 
Inhaler and inhale slowly but deeply. The relief is immediate and 
if used three or four times a day, of five minutes each, will, with 
proper internal remedies and due attention to diet, prove curative. 
Our favorite prescription is 

1$. — Iodide of Potash, . . . . three drams, 
Tincture of Belladonna, . . . one dram, 
Chloroform or Sulphuric Ether, . two drams, 

Simple Syrup, three ounces. 

Mix. 

Dose, a teaspoonful three or four times daily. After using this for 
a week, the first article m^y be increased in quantity. This does bet- 
ter with the dry asthma than the catarrhal kind, which may require 
medicated spray, as in catarrh. It will relieve the difficulty in breath- 
ing. Look for spinal irritation and if pressure upon the backbone 
induces cough, apply the liniment— 
Vf — Tincture of Arnica flowers, 
Tincture of Aconite root, 

Laudanum, in equal parts. 

Mix. 

Moisten flannel folded to two inches in width and six in length and 
lay upon the spine, fastening by a cord about the neck and one about 
the body if convenient. Some physicians use a flannel disk covered 
with rubber or oil-silk and wet with chloroform, which they apply to 
the spine, removing when the burning becomes unbearable. The 
same is applied to the breastbone to relieve difficult breathing. 

Asthma is so intimately connected with other diseases or is so ag- 
gravated by them, that its < ure is only possible when such derange- 
ments are removed . Dyspepsia stands first and consequently all in- 
digestable foods should be avoided. Some an ivies of diet tend to 
cause asthmatic attacks, notably eggs. Suppers should be light and, 
if late, omitted altogether; breakfast should be served early and con- 



452 MEDICAL PRACTICE. 

atitute the principal meal. Bronchitis and heart diseases, of course, 
need special treatment. 

Hay Fever, Hay Asthma, Summer Catarrh, Rose Catarrh. — 
Catarrhm uEstivus. 

It is doubtful whether hay has any influence in producing this catarrh. 
Some ascribe it to pollen of certain plants, some to pollen in general, 
while more recent investigators believe it to be brought about by mi- 
croscopical parasites. Its appearance, repeated every Summer, may 
be the basis of its theoretical connection with vegetable growth. 
It suffices us to know that we can cure it. It manifests itself by vio- 
lent and protracted sneezing, a free discharge of thin, irritating 
mucus from the eyes and nose, a sensation of suffocation, inflamed 
nose, snuffling, cough, headache and sometimes fever and prostration. 

TREATMENT. 

Thousands of dollars are spent annually by these sufferers in trips 
to the seaside or mountains to escape attack or abate one in progress. 
The change certainly affords relief but it is expensive. Some physi- 
cians prescribe a weak solution of tannin in water to be snuffed up 
the nostrils and toughen the membrane. If the paroxysm occurs 
they use a solution of the permanganate of potash with prompt but 
temporary benefit. Our favorite remedies are a solution (French) of 
phenol or the neutral solution of sulphate of quinia ; the character of 
the discharge will determine which. These are used by the atomizer 
as recommended in catarrh. It not only immediately cures but 
seems to cure permanently, as in only a few instances have the at- 
tacks recurred in the seasons following. 



I dodt bnch object to a sdeeze dow a'd thed, 

It wakeds wud up, a'd it clears out the head— 

But, whed wud is sdeezi'g frob borlig to dight, 

It's rather bodotolous— ab I dot right ? 

I subtibes quite fadcy by head will cub off 

Id wud of these sdeezes — they're worse tbad a cough. 






PLEURISY. 458 

A cough tears your ludgs, but a sdeeze tears yon through— 

A'd— gooddess— It's cubbi'g— a— tschoo !— A— tschoo ! 

That sdeeze was a bild wud— I thidk subthi'g wedt 

Idside of by head— p'raps by brain-pad is redt, 

That's dothi'g to what it cad do whed it tries ! 

It rips through by chest, a'd tears out by eyes, 

By dose a'd by bouth, with a shiveri'g crash, 

That shatters by frabe wud horrible sbash ! 

Ah ! that is a sdeeze ! Whed it cubs it's a crusher— 

A'd— oh ! it is cubbi'g— ar— r— ruschah !— Ar— r— r— rusch— ah ! 

— Punch. 
Pleurisy. — Pleuritis. 

Pleurisy is an inflammation of the lining membrane of the chest. 
This membrane not only covers the walls of this cavity, but is reflect- 
ed backward over the lungs. Pleurisy results from colds and ex- 
posure sudden checked respiration and other causes which cohstrict 
the skin and congest internal parts. In some instances the disease 
is confined to that part covering the internal walls of the thorax, but 
being so closely connected with the lungs, these organs seldom 
escape the effects of the spreading inflammation ; and hence most 
cases are observed to be complicated, if only to a slight degree. The 
principal sign of the presence of pleurisy, is a sharp cutting pain 
just within the ribs, not always constant, but occurring always upon 
taking a long breath or coughing and sometimes upon attempting to 
speak. With this pain is generally febrile symptoms (but slight in 
comparison with pneumonia) feeble but hurried respiration and 
usually a short, dry, hacking cough. Should a part of one or both 
lungs become affected, the expectoration may change from a frothy 
to a mucous character, and even the sputa be streaked with blood. 
When both pleura and lungs are involved, we have to a greater or 
less extent the combined symptoms of pleurisy and pneumonia. 
This is what is termed pleuro -pneumonia. 

As the pleuritic inflammation continues, one or both of two things 
may happen. Either those portions which touch and slip upon each 
other in health adhere, or dropsy (serous effusion) may supervene. 



454 MEDICAL PRACTICE. 

In the first instance, upon applying the ear to the chest a friction 
sound will be noticed. In the second, the side becomes enlarged, 
the spaces between ihe ribs less distinct, and from the density of the 
fluid, respiration in the lung may be lost to the listening ear. A 
simple method of discovering the presence of serum is to have the 
patient sit up and to percuss the affected side. This is done by lay- 
ing the middle finger of one band across the ribs at the lower part 
of the chest and with the end of the middle finger of the other, strike 
a blow as if hammering. The resultant sound will be dull and con- 
trast greatly with percussion upon the other side or upon the upper 
part of the chest. It is implied in the above description that the in- 
flammation is confined to one side, which is more frequently the case. 
The patient prefers to lie upon the affected side. 

It is distinguished from pneumonia by its having its characteristic 
sharp pain, its dry cough, the swollen side, and the evidence fur- 
nished by oscultation and percussion. In pneumonia the pain is 
dull and deep-seated, the fever greater, the pulse more rapid and ex- 
pectoration more profuse. It might be confounded with neuralgic 
rheumatism (pleurodynia) of the chest walls, if there is a sharp and 
severe pain and diminished respiratory action. This latter is entirely 
owing to involuntary restriction of the natural effort at respiration, 
but the pain wanders from one part to another, is not limited to one 
side, and we miss the fever, and friction and cough of pleurisy. 

The indications are to reduce the fever and inflammatory action, to 
relieve the pain and to prevent effusion, or if it accumulates in a dis- 
tressing or disturbing quantity, to remove it. 

TREATMENT. 

By the spirit-vapor bath and by the local application of the hot 
pa -k at the se it of the pain, together with the use of veratrum, the 
first two indications are met. The latter should be given to an 
adult as follows : 



PNEUMONIA. 455 

]$. — Tincture Veratrum (green root) forty-eight to sixty drops, 
Essence of Wintergreen, . ten drops, 

Water, . : sixteen teaspoonfuls. 

Mix. 

Give a teaspoonful every two hours until the pulse falls to eighty 

or seveisty, and then less frequently, holding the pulse at this count 

for forty-eight hours. As soon as the attack is known to be pleurisy 

give 

3$. — Podophyllin, ..... two grains, 
Cream of Tartar, .... half an ounce. 
Mix thoroughly and make four powders. Give one in syrup every 
four hours until copious watery alvine discharges. This changes the 
locality of the irritation from the pleura to the bowels find also pre- 
vents serous effusion. The spirit bath is also beneficial in this par- 
ticular. By the above treatment the accumulation of fluid in the 
chest seldom happens. If it does, it may be necessary to apply to 
the surgeon for relief, which is obtained by drawing off the water 
by the use of the aspirator, an instrument made for this particular 
purpose. 

Lung Feveb. — Pneumonia. 

Pneumonia, or acute inflammation of the lung substance, is a 
serious disorder, though its fatality has been diminished by an im- 
proved practice. The disease is commonly ushered in by restlessness., 
with general febrile disturbance. At the end of one to three daya 
there are rigors, soon followed by nausea, cough, pain in the side, 
distressed breathing, a pulse reaching to 140, or even 160 beats in the 
minute, burning heat of the skin, thirst, hiss of appetite, prostration, 
headache, and sometimes transient delirium. Frequently no notice 
is taken of the primary restlessness, so that the patient describes the 
succession of his symptoms as shivering, fever, cough and breath- 
lessness; and these four symptoms with pain, cover the disease. 

Each case of pneumonia may be said to consi t of four stages, viz., 



456 MEDICAL PRACTICE. 

first, congestion of the pulmonary membrane with dryness; second, 
engorgement : third, hepatization; fourth, purulent infiltration. 

In each stage there is fever, the temperature rising the first day to 
101°, or even 102°. and gradually increasing -until the fifth or sixth 
day, when it may be as high as 105° Fahrenheit. Next we have more 
or less pain in some portion of the chest, most severe at the com- 
mencement, together with accelerated and oppressed breathing. 
There is great depression wiih occasional delirium, and then we find 
a very distressing cough, with expectoration of viscid, rust-colored 
sputa, which unites in a mass so tenacious that even inversion of the 
vessel in which it lies will not detach any portion of it. The blood 
always contains an excess of fibrine,.eonsequently there is danger 
that coagula may form in the right side of the heart or in the pul- 
monary arteries, giving rise to urgent dyspnoea, or even sudden 
death. 

In the first stage, that of dryness of the pulmonary membranes, 
there is a dry harsh respiratory murmur. The skin is hot and dry, 
the pulse and respiration frequent, and there may be pain over the 
affected side. The duration of this stage does not exceed twenty- 
four hours. The second s'age, or that of engorgement, is that in 
which the air-cells of the affected part of the lung become loaded 
with blood or bloody serum. If the chest be list< ned to when the 
lung is in this condition a sound will be heard closely resembling 
that of a lock of one's own hair rubbed between the finger and thumb 
close to the ear. 

Where the infl ; mmation proceeds, it passes into the third stage, or 
that of hepatization, in which the spongy character of the lung is 
qui'e lost, and the texture becomes hard and solid, lesembling the 
cut surface of the liver; h< nee the name hepa'ized. The resonance 
on percussion is dull over the whole of the affected parts. 

Advancing still further, we have the fourth stage of pneumonia, or 
that of purulent in 111 i ration, which consists of diffused suppuration 
of the pulmonary tissue, parts of the lungs remaining der se and 
imp< rmeable. There are no physical sigus of this stage until parts 



PNEUMONIA. 457 

of the lungs break down and the pus is expectorated. If the inflam- 
mation subsid s before the sta_ r e of purulent infiltration, as it for- 
tunately ofien dors, then the febrile disturbance decreases, the tem- 
perature drops toward its natural standard, the cough becomes less 
irritable, and thf general distress mitigates. Still the frequency of 
the pul?e and the hurried breaihing continue until the lung begins to 
lose its solidity. 

Pneumonia may affect one or both lungs, or, technically speaking, 
it may be double or single. The right lung suffers nearly twice as 
often a< the left. The lower lobes are more subject to inflammation 
than the upper. 

It is distinguished from dropsy of the lung, which is slow in its 
development and accompanies watery effusion in other parts of the 
body; and from pleurisy, which has sharp pain, cough without expec- 
toration, frothy sputa not rust-colored, enlargement of the side and 
only slight feverish symptoms. 

Tlie indications are to reduce the inflammation, open the excretory 
organs, control the fever and prevent hepatization. 

TREATMENT. 

A cathartic of calcined magnesia is of advantage in unloading and 
cleansing the stomach and bowels, preparing them for the absorption 
of medicines. Draughts of warm lemonade taken an hour or two 
after will hasten its action and tend to relieve the lung by a metasta- 
sis of irritation to the bowel. Internally should be administered 
every two hours two or three drop doses of tincture of veratrum 
viride. A flannel jacket should be made to fit the chest, but loose 
enough to enclose when buttoned, four or more thicknesses of flannel 
extending from the neck to the navel, and reaching three-fourths of 
the distance around the body. This flannel envelope should be 
wrung out of hot water, and after sprinkling: with a tablespoonful 
of the veratrum, be applied snugly and smoothly over and around 
the whole chest as far as possible. 

When it is convenient a large linseed meal poultice into which has 
been thoroughly mixed the veratrum may be applied to the chest and 
20 



458 MEDICAL PRACTICE. 

secured by the jacket or bandage. These should be changed as fre- 
quently as they become cool. If perspiration docs not occur, the rub^ 
her bag, filled with hot water, may be applied to the feet. In the 
very young it may be better to subs:itute aconite for veratrum. 
Water or lemonade may be used as a drink and milk may be given 
for food. The temperature of the room should be kept at seventy 
degrees and the air slightly moistened by steam. 



LUNG DISEASES. 459 



CONSUMPTION. Phthisis Pulmonalis. 

Strictly speaking, the term consumption is applicable to most 
chronic diseases, for few terminate or exist for any length of time 
■without the wasting away of the body or some of iis parts. The 
emaciation in phthisis pulmonalis, or wasting away of the lungs, is so 
apparent and unfortunately so common that consumption has come 
to signify lung disease in particular. The middle-aged are most 
often attacked. Those of consumptive parents or with parents tem- 
peramentally inadapted or with scrofulous or phthisical family his- 
tory are most liable. The temperate zone produces a greater num- 
ber of cases than the torrid or frigid zones. Its duration is from six 
months to three years, depending upon its severity, the vitality of 
the patient, his occupation, his habits and hygienic surroundings, 
Cases occur in which a fatal termination is not delayed to a half year, 
This is termed, from its rapidity, galloping or hasty consumption, 
This type is confined to the young, to those who have been greaily de- 
bilitated by exhaustive diseases, including secret vices and sexual ex 
cesses, and the finely but feebly organized, who have been largely 
medicated with such minerals as mercury, antimony and the like. 
Consumption invariably preys upon the scrofulous, but there is a 
variety called scrofulous consumption. Here there is a change in the 
seat of the disease, from the swollen glands or from the surface in 
eruptive fevers, to the lungs, which, with greater or less rapidity, ul- 
cerate and decay. Specific diseases like cancer, syphilis, etc., are 
prolific and powerful causes. 

The symptoms of pulmonary consumption are manifold: A cough 
slight at first and occurring on rising in the morning, afterward 



460 



MEDICAL PRACTICE. 



hacking, constant and wor=p at night; dry or with expectoration of 
frothy mucus, afterward viscid and opaque nnd mixed with small 
round particles of tubercular matter or streaked with blood; occa- 
sional spitting of blood or hemorrhage from the lungs; hectic fever, 
circumscribe 1 redness on the cheeks during the fever and pale at 
other times; increased lustre of the (ye and clearness of intellect; 
tongue white and, at a later period, red. The chest, fails in its full ex- 
pansion and flittens on the affected side; pains in the chest resem- 
bling those of rheumatic origin. Shortness of breath, increased by 
exertion, languor, weakness and loss of flesh, chilliness followed by 
flushes of heat, burning in hands and soles of feet, blue fingers with 
rounded nails, red lines around gums, headache, sore throat, catarrh, 
derangements of the stomach, quick and feeble pulse, diarrhoea, 
night-sweats and suppressed menses are symptoms that are present 
in most cases at some period. The most constant are the cough, 
hemorrhage, hectic and debility. There are signs even more positive 
than these and which determine the malady beyond question. As 
the upper lung (the part more commonly involved) becomes filled 
with tubercles, percussion returns a dull sound to the experienced 
ear, showing consolidation. Later softening takes place and cavities 




INSTRUMENTS FOR PERCUSSING. 

are formed, when a gurgling sound, like air passing through water, is 
heard. Other results of auscultation and percussion might be 
mentioned if space would permit. 

We pass at once to ihe consideration of tubercle. What is it, and 
how is it formed ? 



CONSUMPTION. 



461 



Insufficient food, want of pure dry air, 
of warmth and of light, long continued 
mental depression, aggravated and long 
continued disease of the digestive organs, 
deficient excretion, the injurious influ- 
ences of fevers and other serious diseases, 
excessive loss of blood or of the more 
annualized secretions and other causes 
which deteriorate vitality, each and all 
depreciate the red corpuscles of the blood, 
the true vital element of that fluid. 
Fibrine is an element of the blood from 
which the areolar and connective tissues 
are formed and this depends upon the red 
corpuscles for its perfect development. 
An excess of fibrine and deficiency of red 
corpuscles are the chief features of a 
scrofulous and tuberculous or consumptive 
constitution. The deposit of tubercle is 
the deposit of fibrine; the two differing, 
not in kind, but in degree of vitality and 
capacity of organization. This low state 
of organizability does not belong to the 
whole mass of the fibrine of the blood, 
else tubercles would be developed in the 
tissues everywhere, but to a small or large 
Stethoscope, used for aus- portion, according to the ratio between the 
cultation, or « lookiug in- red globuh s and the fibrine. It escapes 
from the blood in the ordinary processes 
of nutrition of the tissues and owes its 
origin to the d graded condition of the nutritive material. The 
change is retrograding _ instead of progressive. Where there is a 
great abundance of this fibrinous substance lli're is an increased 
tendency to deposit, which is greatly promoted by all varieties of 




to one's chest with your 
ears." 



463 MEDICAL PRACTICE. 

congestion or inflammation and prevails most in organs which re- 
ceive the largest supply of blood. This explains the peculiarly per- 
nicious influence of inflammation of internal organs especially of 
the lungs, in scrofulous persons. There are several circumstances 
which contribute to render the lungs especially liable to tubercular 
deposit : 

First. Their great vascularity or fulness of vessels and the great 
amount of blood that flows through them; 

Second. Be ng the chief seat of the formation of fibrine; 

Third. The softness and yielding nature of their textures which 
permits effu-ion to take place more readily than in denser textures; 

Fburth. The exposure to external causes of disease, whether it be 
cold or irritating substances entering by the air-tubes or causes oper- 
ating through the circulation. In hot climates tuberculous deposits 
occur in the liver and other abdominal viscera more frequently than 
in the lungs, and chronic liver disease and dysentery are the results 
in such persons as would in a colder climate fall victims to consump- 
tion. The lungs and bronchial glands are by far the most comnjon 
seat of tubercles and even when found elsewhere, are commonly 
more abundant there and in a more advanced stage. 

By this we mean softening. Rokitansky thus describes it; "After 
the tubercle has existed for some time in a state of crudity, it be- 
comes, as it were, loosened in its texture and usually increas-es ia 
volume; it breaks up on slight pressure and becomes more moist; 
then changes into a yellowish dissolving, casein-like, fatty and viscid 
matter and finally breaks up into a thin whey-like acid fluid, in 
which flocks and shreds, the remains of the imperfectly disintegrated 
tubercle, are observed swimming. This is tubercular pus." 

The pressure upon the walls of the cells and tubes may cause their 
ulceration and the pus penetrating the tubercular mass hastens the 
process of disintegration and rapidly forming abscesses may follow. 
Depositions of the firmer kind of tubercle may remain without giving 
any marked evidences of their presence, or at least, without creating 
much disturbance; but when they change and the disintegrating par- 



CONSUMPTION. 463 

tides become liquified and thrown off in copious expectoration from 
the lungs, or in diarrhoea from the bowels, the patient experiences 
rapid changes, becomes exhausted, hectic, and soon dies. When 
the substance effused is the yellow form of tubercle, he is soon wasted 
away with rapid consumption, for this form is low in the grade of 
deposits and is associated with a weak resisting power of the consti- 
tution. The expectoration and diarrhoea are often accompanied with 
local inflammation, developed around the seat of deposit, and care 
should be taken in combatting the inflammation we do not weaken an 
already greatly enfeebled vitality of the system. 

It is distinguished from chronic bronchitis chiefly by the absence of 
dullness upon percussion in the latter; from chronic pneumonia by 
the history of the acute attack of pneumonia and the dullness being 
confined to the lower lobe of one lung; from chronic pleurisy by the 
acute attack, the lowerpart only being involved, no spitting of blood 
and less active cough, emaciation and night sweats; from pulmonary 
abscess by the cavity being in the lower lobe only. The cough of a 
common cold is readily recognized, but should receive special atten- 
tion from those of consumptive tendency. The difficult breathing 
of asthma can hardly be confounded with that of phthisis, beside 
the two diseases are seldom conjoined. 

Haemoptysis, or hemorrhage from the lung, is an unpleasant event, 
but not so alarming as many believe. A matter of the greatest im- 
portance is the determination of the place from whence the blood 
proceeds. Investigate the gums to see if they are spongy, the throat 
for soreness and inflammation, the na^al cavity for catarrhal hemor- 
rhage. The stomach may emit blood, but its appearance is preceded 
by a sense of weight and uneasiness, and the blood is always dark- 
colored, having been acted upon by the gastric juices. Pains in the 
chest indicate the presence of consumption, but are not of them- 
selves conclusive evidence. They may be of rheumatic character, of 
neuralgic, or due to organic changes from recent pleurisy or pneu- 
monia. Diarrhoea swelling of the limbs and night sweats, may be 
traced to other causes and conditions than the one under considera- 



464 



MEDICAL PRACTICE. 



tion. Occurring in consumption they are 
unfavorable symptoms but not always 
be ond the realm of relief. The suppres- 
sion of menstruation is significant, but 
may be effected by causes such as would 
operate if no pulinon iry complaint ex- 
isted. Child-bearing and nursing se- 
verely tax the physical system of 
most mothers, but since, in a few excep- 
tional instances it has been inferred that 
these have prolonged life, pregnancy has 
been recommended to ihe consumptive as 
salutary. The majority are unable to bear 
the over-burdtn and spee ily succumb. 
The results upon the ill-fated and doomed 
offspring are horrible to contemplate. 

Tlie indications are to introduce pure air 
abundantly into the lungs, strengthen 
these organs, and expand the chest, to 
enrich the bl >od, increase and vitalize the 
red corpuscles, stimulate the skin and ex- 
cretory organs so as to secure the elimin- 
ation of abnormal deposits and of effete 
and useless materials, and relieve all irri- 
tation, whether of the throat, chest, 
stomach or bowels. 

TREATMENT. 

The patient should under all circum- 
stances take the air as much as possible, 
unless too feeble to exercise. In our day 
there is little excuse for being confined to 

the house on account of rainy weather. With water proofs, rubber 
bo«»ts, gloves and umbrella, the chances of getting wet are reduced to 
u minimum. The air is purer during and just subsequent to a 




Apparatus for employing 
compressed air. 



CONSUMPTION. 465 

shower. High winds are to be avoided. Exercise should always 
be discontinued before fatigue. Expansion of the chest should 
be practiced by inhaling into the lungs as much air as possible, 
and closing the lips all but a small opening, pass it out s'owly, 
that it may remain in - contact with the blood longer than it 
otherwise would, for its more thorough decarbonization and higher 
oxygenation. An instrument has been invented by Dr. Ramadge 
of England — a small tube, funnel-shaped, at each end, one of which 
is larger than the other — for the purpose of assisting the patient in 
slow inspiration and expiration. It is said that the discovery of 
this method of cure was accidental and occurred in this way: a con- 
sumptive in one of the English hospitals was affected with a tumor 
in the neck which pressed upon the windpipe. As the tumor in- 
creased the pressure caused the gradual closing of the air passage 
until breathing could only be accomplished with the greatest diffi- 
culty. To the surprise of all it was noticed that simultaneously the 
chest was expanding, ihe lungs enlarging and healing. The faculty 
concluded to delay the removal of the tumor and await the result. 
In six months the lungs were pronounced healed and the trouble- 
some blessing was removed. 

My respirator is admirably adapted to the purpose and enables 
any one to increase iheir breathing capacity to a ver}^ remarkable 
degree. It is beneficial to public speakers, readers and singers, to 
teachers and others; in fact, it has an extensive sphere of usefulness. 
It consists of a hard wood body and ivory ends. One end is a mouth- 




KBSPIRATOB. 

piece and the other is trumpet-shaped. Within is an ivory valve 
so adjusted that inspiration is free or only slightly intercepted, while 
expiration is sufficiently hindered and retarded to effect the desired 
purpose. Thus the blood of the consumptive is rendered purer and 



466 



MEDICAL PRACTICE. 



more highly vitalized and the pressure of ihe inspired air, slowly 
expired, forces open the air tubes which are being pressed together 
by the deposits, and crowding upon those deposits, causes their 
absorption ; and, also, by pressing together the walls of any newly 
formed cavities such as come into existence in early consumption, 
causes their adhesion. This result is certainly very desirable, since 
abscesses and tubercular masses tend to encroach upon the healthier 
parts of the lung, if the lung cannot be made, or is not able, to act 
upon them. Oxygen is the great purifier, the great burner of these 
deposits. But why not use it pure, as it can readily be manufactured, 
and by rubber bags stored and curried about ? Simply this : experi- 
ence proves that while it seems to 
benefit at first, eventually it pro- 
duces acute inflammation of the 
lungs. The numerous oxygen 
inhalers, if th( y evolved oxygen, 
(which they do not), would be 
subject to this objection. In the 
air as we find it, oxygen is rem- 
edial, the chemically prepared is 
an oevrdose, is poisonous. The 
expansion of tie chest by the 
Respirator, is soon noticeable and 
has, in some instances, increased 
in circumference four inches in 
the short space of two months. 
Larger chest mean? larger lungs, 
larger bellows to feed the flame 
of life. 

This inspiration and expiration 
of air is accomplished by the 

8p,RO>,E cI^ it TonSe^° ri " gthe wh ° le ^ s >- and mai "iy "y ,hc 

diaphragm and abdominal muscles. A two-fold purpose is accom- 
plished, namely, that just mentioned, and a new impetus is ^ivcu to 




CONSUMPTION. 



473 



Dr. Paul Niemeyer, in writing upon this subject, presents many 
plain and practical points. We use his language : " The apices are 
a veritable receptacle for mucus, which, if not removed, dries up, 
grows hard, and causes ulceration. In one hundred autopsies we 
find as many as ninety cases where the apices are more or less 
shrunken, scarred and obstructed, and this without reference to the 
cause of death. 

The apices, furthermore, are regular dust and gas traps, especially 
the right apex, which usually is the first to be affected by consump- 
tion, because the air-passage leading to it 
is wider and less crooked than that lead- 
ing to the left apex. All impurities in- 
haled into the lungs, and especially all 
dust, first make their way to the apices 
and there settle, unless they are kept in 
motion by bodily exercise. Elimination, 
too, is more difficult in the apices than 
in the inferior lobes. In coughing, the 
latter are aided by the abdominal pressure, 
w.ile the apices on the contrary, have to 

depend on their own contractility, which 
Anti-dust Respirator, to be 

used in Mills, Mines and Fac- is weaker in proportion as they have been 
tories as a preventive of lead- „ . ,, . ., .. . 

poisoning, salivation and out of exercise, or as their cell-walls have 
consumption. Invaluable to , ., 

farmers while threshing. grown together. 

In addition to these causes heavy clothing, which, like the yoke 
for carrying water, bears on the collar-bone, diminishes the power of 
respiration in the apices ; a modern winter overcoat weighs as much 
as eight or nine pounds. Hence the troublesome dry cough, which 
often ends in vomiting, yet does not loosen the mucus in the lungs. 

That pulmonary consumption is only an acquired disease we know 
from the fact that it first appears in the apices of the lungs— a por- 
tion of the organ which is not affected by hereditary pathological 
processes. The diathesis only is hereditary, and this diathesis con- 




474 MEDICAL PRACTICE. 

n*ts simply of a general debility, which, however, can be overcome. 
But the thing that is transmitted hereditarily is habits of life" 

It r< quires considerable effort on ihe part of a physician to convince 
a patient of the importance of the fact that great will power is as 
ne «8sary as medicine. Without it the prognosis or forecast is unfa- 
vorable. This class of invalids is hopeful and credulous, and, in 
some respects, it is w T ell that it is so. Hope buries many a past suf- 
fering and clouds in darkness the slow and stealthy steps of this 
d' stroyer. Credulity can be used to advantage by an experienced 
and conscientious physician, but is, with equal facility, diverted by 
the quacks and imposors who trade in human life and induce the 
invalid to swallow "mixtures" w T ith impossible healing powers, 
some of which stimulate, others narcotize and all almost invariably 
harm. 

When ambition is aroused and good resolutions formed, the con- 
sumptive is on the road to recovery. How far progress will be made 
in the journey depends on the amount of perseverance. Not spas- 
modic perseverance, but persistent and continued. If he wills not 
to die, he can oft n live in spite of disease; and. if he has little or 
no attachment to life, he will slip away as easily as a child will fall 
asleep. Men live by their minds as well as their bodies. Their 
bodies have no life of themselves; they are only receptacles of life; 
tenements for their minds; and the will has mu( h to do in continuing 
the physical occupancy or giving it up. The disease is working in- 
cessantly and the afflicted must do likewise. The condition may be 
thus mathematically stated. If by hygienic and medical means at the 
end of a day you have progressed a certain distance and the disease 
has progressed as far, you are no better and no worse; if the disease 
has progressed farther, you are certainly worse; this is self-evident. 
But if you have made more progress than the disease, you have an 
advantage, — ecuring which, keep it. What we want to impress upon 
the reader is this : that one factor is unceasingly in operation, and 
the other must be as continually active. 



LUNG DISEASES. 475 

Other Diseases of the Lungs. 

There are other diseases of the lungs, some of them amenable to 
treatment and some not. We can only give them brief mention and 
this is done to show that consumption is not the only dangerous ail- 
ment of the lungs and that some of these are more emphatically in- 
curable. 

Wind Dropsy. — Emphysema. Here the lung is inflated, the air- 
cells being enlarged and distended. Such a condition sometimes fol- 
lows asthma or results from a trade compelling much exposure to 
the weather. From appearances the person would be considered as 
having large lungs, the chest is so prominent and bulging. A closer 
inspection finds the breath short and breathing difficult, taxing the 
strength almost to its limit. The inspiration is quick and feeble and 
the expiration (breathing out) slow, noisy and laborious. Sonn times 
the liver or heart is displaced. Symptoms of heart disease are not 
uncommon. 

Wind in the Chest. — Pneumothorax. From injury and other 
caus s wind sometimes enters the" cavity of the pleura, in other words, 
gets between the lungs and chest-walls. The prominence is present, 
but only on one side: rapping the affected side gives a drum-head 
sound, breathing is more difficult and lying down almost impossible. 

Abscess of the Lung. — Pncumotostema. Abscess may follow 
pneumonia but it is seldom suspected until it opens or is discovered, 
unless the lungs are previously examined by an expert physician. The 
constitutional symp f oms are those of abscesses; chills, fever, hectic, 
etc. When the abscess opens it discharges into the chest, or more com- 
monly into the air-!ubes and the purulent matter reaches the mouth. 
In the scrofulous, purulent matter, offensive and bloody, may dis- 
charge, but in such a case it is more likHy to be gangrene of the lung 
(necronneumonia), a decay of its substance. 

Collapse of the Lung. — Atelectasis. In severe bronchitis nnd 
whoouimr-cough the air-cells have been known to collapse; a fatal 
condition but fortunately rarely occurring. 



476 MEDICAL PRACTICE. 

Pulmonary AroPLEXY is another of these terrible lung affections. 
The flow of blood may be so great as to overwhelm the lung, prevent 
respiration and destroy life. The majority of cases of sudden death 
that are attributed to "heart disease" are cases of apoplexy of the 
lungs. 

Short Breath, Difficult Breathing. — Dyspnaia. 

Dyspnoea is a symp'om of man}' diseases but specially diagnostic 
of none. It is an accompaniment of diseases of the heart, lungs, 
pleura, diaphragm, brain and spinal cord: appears also in obstruc- 
tions of the air passages and in fatness and conditions of the abdomen 
in which the diaphragm or midriff is crowded upward, such as tu- 
mors, pregnancy, etc. There are few lung or chest diseases without 
difficult breathing; in asthma it constitutes the chief feature of the 
disease. In angina of the heart it is second to the severe pain. In 
pulmonary and pleuritic affecti ns the inflammation may be followed 
by effusion of water, blood or pus, into the pleural cavities and 
this presents a barrier to the expansion of the lungs. Diseases of 
the nervous system, attended with palpitation, congest the lungs and 
render respiration difficult. Rapid breathing, however, is not always 
difficult breathinsr. Fright, startling news, shocking sights and other 
causes producing great excitement, either mental or physical, engender 
labored breathing. Paralysis of the diaphragm is a serious source 
of dyspnoea. It occurs in the debilitated after the slightest exercise. 
Travelers upon mountain tops experience it from breathing the rari- 
fied air. The a' tack then resembles sea-sickness together with treat 
pain and throbbing in the head. No general line of treatment can 
be given, but each case must be considered separately. 

Foreign Substances in the Trachea (Air-passage.) 

Children are likely to suddenly draw beads, beans, coins, or other 
playthings into the air passage. Although the distress may be great 
and the paroxysms of coughing violent, yet they may remain for 



SUSPENDED ANIMATION. 477 

weeks, and even for months, without doing any greater harm than 
the coughing. By some peculiarity of position or while lying down, 
an extraordinary fit of coughing expels them. The danger from an 
operation by opening a passage into the windpipe just above the 
breastbone, is so great that it should not be attempted unless some- 
thing beside the coughing seems to threaten life. The trachea ha^ 
been opened and yet the operation proved unsuccessful because of 
the severe paroxysms caused by an a: tempt to introduce instruments 
into the tube. 

TREATMENT. 

Hold a child by the legs or ankles, head downward. This will be 
likely to provoke a paroxysm and the substance will be ejected. If 
unsuccessful in the first attempt, af u r sufficient rest, repeat the ope- 
ration. No hat m can come from repeated trials. The adult is sel- 
dom trouble 1 in this way. If such an accident should happen, place 
the hips upon a bed with the hands upon the floor and cough. A 
bystander may assist by applying vigorous blows upon the back just 
below the shoulder-blade. 

Suspended Animation, Suffocation.— Asphyxia. 

The medical term, asphyxia, signifies without pulse, pulseless. 
This does not fully express the condition, for about i he first thing no- 
ticed by the observer is that the breathing is imperfectly performed 
or stopped entirely. Insensible breathing or absence of respiration 
physicians call apneea. Of course, if the circulation and respiration 
are absolutely at rest, the person is dead. But as this may be only 
apparent and not real, we are morally bound to make every effort in 
our power to revive the individual. It is astonishing how lo g a per- 
son may be asphyxiated and yet recovn* consciousness; providing 
always that proper means are employed and continued without inter- 
mission, it may be for a half hour, an hour, or even two hours. A 
gasp from the almost lifeless body will send a thrill of delight 



478 MEDICAL PRACTICE. 

through your frame that you will never forget and will amply repay 
you for all }'our labors. 

Suspended animation results from some obstruction to the access 
of air to the lungs, as a bolus of food lodged in the throat and closing 
the air passages, by constriction about the neck, as in strangling, or 
by the inhalation of poisonous gases; the effect in all cases being 
that the blue blood in the lungs is not converted into the red and 
life-sustaining arterial fluid. At this moment we think of but one 
exception and that is in the new-born, when there is a want of ner- 
vous stimulus. 

It occurs by drowning, smothering, strangling and hanging. The 
object in legal hanging is to dislocate the bones of the neck, and. by 
pressure upon the spinal cord, extinguish life; but. in the bungling 
manner in which it is usually done, it is little else than strangling. 
The poisonous gases are prolific causes of asphyxia. The heavy 
carbonic acid gas settles in old wells, mines and brewers' vats. A 
person lowered into this is suddenly struck insensible. If not imme- 
diately rescued, death ensues. Another should be sent to the rescue 
at once. Care should be exercised that the second party is not sub- 
merged in the gas for a longer time than a person can ordinarily 
hold his breath, or he, too, may be stricken. If unsuccessful in se- 
curing the victim, better return to the surface for breath and try 
again. Fresh dry charcoal is a powerful absorbent of this gas. The 
w r ell may be freed by lowering a basket of charcoal into the gas f-»r 
ten or fifteen minutes. This should then be withdrawn and a fresh 
supply substituted, or the first lot heated and again used. When a 
lighted candle can be let clown to the bottom without extinguishing 
the flame, no gas is present. It is best in all cases to try this simple 
test before making the descent. Suffocation not unfrequently follows 
the escape of the common burning gas into unventilated sleeping 
apartments. People in our northern latitudes in winter are poisoned, 
and sometimes asphyxiated by closing the drafts of cast iron stoves 
too closely at night. Economy of fuel is laud ible, but in this mat- 
ter there are ether and more weighty considerations. The fumes 



ARTIFICIAL RESPIRATION. 479 

' from burning charcoal are still more potent. Life is oftener lost in 
burning buildings from the asphyxia produced by the smoke than by 
the flames themselves. Our firemen frequently rescue from bed- 
rooms or dormitories yet untouched by the fire, both children and 
adults in an insensible condition, caused by this agent. 

TREATMENT. 

No matter what the cause, the first indications are to restore res- 
piration and circulation of blood. The latter is accomplished by 
friction of the surface, and the former, which is of most importance, 
by a method termed "artificial respiration," which we will presently 
consider. When breathing is fairly established, stimulants may be 
administered — brandy, whisky, carbonate of ammonia, or 

1^.— Chloroform, one dram, 

Comp. Spirits of Lavender, . . . one ounce. 

Mix. 
In small doses, repeated at short intervals. Rest and a full supply of 
fresh air are not to be overlooked. 



ARTIFICIAL RESPIRATION. 
To Restore Persons Apparently Dead. 

The "direct method," as it is called by Dr. Benjamin Howard, U. 
S. A. , its originator, is superior to that of Marshall Hall or Dr. Syl- 
vester. "We quote from the Lancet, which gives a report of his lec- 
ture to a college class, altering the language to suit the new audi- 
ence. The directions apply particularly to the resuscitation of the 
drowning, but can, without difficulty, be varied to suit asphyxia 
from other causes : 

Instantly rip away Ms wet clothing to the waist, and of it make a 
large, firm, solid bolster. 

Quickly turning the face dmonward, place the bolster beneath the belly, 
making that the highest point, the mouth the lowest. Place both 
hands upon tlie back, immedia'ely above the bolster, and throw your 



480 MEDICAL PRACTICE. 

whole weight forcibly forward, compressing the stomach and lower 
part of the chest between your ban is and the bolster for a few sec- 
onds, tiro or three times, with very short intervals. 

Thorough drainage being combined with thorough compression, 
the lungs, if they require it, are relievrd of water, and the stomach, 
if distended, of its surplus contents, forcible ejection making the 
process pretty complete. Should this effort happen to have bee n 
superfluous, no time has been lost, an efficient means of artificial 
respiration having by this process been already commenced. 

Quickly turn the patient on, his back, the bolster beneath it making 
again the belly and front margins of the ribs the highest point of 
the body, the shoulders and head resting on the ground. 

Seize tlie patient's wrists, and having secured the utmost possible 
extens ; on with them cross behind his liead and pin to the ground with 
your left hand. 

With tlie right thumb and forefinger covered with tlie corner of a dry 
pocket handker 'chief, witlidraw the tip of tlie tongu\ holding it out of the 
extreme right earner of tlie mouth. This is the easiest, least barbarous, 
and firmest way of holding the tongue. If an assistant be at hand, 
both wrists and tongue may be confided to his care. 

In this position two-thirds of the entrance to the mouth is quite 
free and the tongue is immovably fixed forward. The valve to the 
upper part of the windpipe is, by this backward curvature of the 
neck, precluded from pressure and partial closure from the undue 
flexion of the neck so frequently occurring. The head, as Nelaton 
urged, is thoroughly dependent. The free ends of the ribs are as 
prominent as they can be made and there is a degree of chest expan- 
sion, not obtainable, I believe, in any other manner. The belly, 
being the highest point, the abdominal contents, instead of embar- 
rassing the movements of the diaphragm, (the muscle separating the 
chest and its contents from the abdomen and its contents) tend to 
gravitate away from it. 

To produce respiration, kneel astride the patient's hip, rest the ball 
of each thumb upon tlie lower part of the breast bone, the fingers falling 



ARTIFICIAL RESPIRATION. 481 

naturally upon the ribs on either side. Resting your elbows against 
your sides and using your knees as a pivot, throw the whole 
weight of your body slowly and steadily forward until your mouth, 
nearly touches the mouth of the patient and while you might slowly ■ 
count one-two-three; then suddenly, by a final push, spring yourself 
back to your first erect position on your knees. Remain there while you 
might slowly count one-two; then repeat; and so on about eight or ten 
times a minute. 

This method is called the " direct method," "because, by it, the few 
things needed to be done, are, simply done. The tongue needs hold- 
ing forward — it is held ; the ribs pressing — they are pressed. It is so 
simple that any one, after a single lesson, can do it as well as the 
always distant physician. It is not fatiguing ; the force employed is 
the weight of the operator, who remains in an easy position with 
alternations of complete rest. It can be practiced by any body, any- 
where ; in a bath, in bed or boat, and such adjunctive measures as 
friction, etc., can be used simultaneously. 
21 



482 MEDICAL PRACTICE. 



ORDER VIII. BOWEL DISEASES. 



Inflammation op the Stomach.— Gastritis. 



The stomach is the most abused organ of the body and the most 
patient and uncomplaining. "When we consider the variety of foods, 
stimulants and condiments, the different kinds of cookery, the fre- 
quency and irregularity in meals, the hard work imposed by over- 
eating, and the fact that it is the centre of so many nerves, we are 
surprised that irritation and inflammation are not more frequent. 

"With gastritis, there is intense thirst and constant burning pain, 
pain upon pressure, nausea, retching and vomiting of food, then 
mucus, then bile and sometimes blood. The disease causes vomiting 
and vomiting may cause the disease. If not soon relieved, there is 
great prostration and depression of the nerves of organic life. It 
attends poisoning, sea-sickness, pregnancy, colic, blows, habitual use 
of alcoholic beverages, etc. 

treatment. 

In this particular your patience may be tried, for sometimes the 
stomach "has a fancy of its own." Try counter-irritation by a 
mustard-paste over the stomach, left on just long enough to give 
redness, repeatedly applied. It may be necessary to give morphine 
in one eighth-grain doses every two hours until the stomach quiets. 
Two to four grains of opium made into a pill, oiled, and passed into 
the rectum, maybe substituted. Sometimes the autacid cordial will 
relieve promptly, viz: 



GASTRITIS. 483 

fy— Fluid Extract of Rhubarb, . . one dram, 

Essence of Spearmint, . . . thirty drops, 

Bicarbonate of Soda, . . . one dram, 

Brandy, two drams, 

Simple Syrup, four ounces. 

Mix. 
Take a teaspoonful every half hour; or 

3$. — Tincture of Valerian, . one ounce, 

Calcined Magnesia, . . . two drams, 

Tincture of Opium, . . . . one or two drams, 
Peppermint water, . . . three ounces, 

Essence of Anise, .... twenty drops. 

Mix. 

Shake well and take in teaspoonful doses. This recipe is of espe- 
cial advantage to chronic cases. It subdues inflammation, gives 
sleep, and it does not constipate the bowels, destroy the appetite, and 
make you feel sick in the morning like morphine. But we have 
seen cases in which ice seemed to be the only thing that would lay 
upon the stomach, even a teaspoonful of water being refused. The 
ice is broken into small lumps and taken in nearly a solid form. In 
gastric irritation in fevers give ice-cream. For sea-sickness give a 
mild sedative like 

1$. — Chloroform, one dram, 

Comp. Spirits of Lavender, . . one ounce. 

Mix. 

Take a teaspoonful every half hour if necessary. The other con- 
ditions mentioned are considered separately in other places under 
their appropriate headings. 

Gastritis, in the chronic form, is a species of dyspepsia, requiring 
bitter tonics, such as the strychnia compounds. 



484 MEDICAL PRACTICE. 

Indigestion, Dyspepsia. 

There are many varieties of this disease and it cannot be cured 
unless treatment is adapted to the particular kind. 

One class is caused by a chronic inflammation of the lining of the 
stomach. There is some pain or uneasiness after meals, tenderness 
on pressure, tendency to vomit, especially if rich or indigestible food 
has been eaten, a sense of thirst after meals, heart-burn, sometimes 
dry tongue, gas in stomach and bowels. After the meal is fully di- 
gested the patient feels better. The tongue is smooth, red and 
glossy, or is white, with red edges. If the inflammation extends to 
the bowels there is tendency to diarrhoea. Bowels usually consti- 
pated. 

TREATMENT. 

The diet should be plain and all irritating and indigestible articles 
of food avoided. Better use whole wheat, cracked wheat, oatmeal, 
rice and fruits of all kinds, providing they are not too acid, which is 
objectionable. Temperance and regularity should characterize the 
patient in every particular, respecting meals, exercise, sleep, etc. 

If acidity of the stomach and constipation are present, use the 
calcined magnesia. The kind of dyspepsia under consideration* is 
accompanied with icnter-brash or the profuse flow of saliva. Some 
have advised smoking tobacco as a relief; but patients smoke thirty 
years and still the water-brash is present. Is there another remedy 
(so called) in which they would persist so faithfully and not 
despair ? 

Another form of dyspepsia is that in which a rel xed condition of 
the mucous membrane of the stomach exists. There is an abundant 
secretion of vitiated gastric juice. Acidity is the prominent symp- 
tom and fermentation of the food takes place both in the stomach 
and bowels. Both are distended with gases and diarrhoea may be 
frequent. The treatment should be stimulating. A good remedy is 
the cold effusion of composition (Beach's). Pepsin is valuable. 



DYSPEPSIA. 485 

Pepsin should be given in most forms of dyspepsia, as it aids and 
hastens stomach digestion and thereby gives the other remedies 
used a better chance to operate. Care and regularity in diet, habits, 
etc. , are necessary to complete the cure. 

A common form of dyspepsia is connected with a deranged and 
torpid conditio a of the liver and inactive bowels. The tongue is 
yellowish or whitish, the urine high colored and scanty. As the 
liver fails to perform its function properly, the kidneys have a de- 
purative action thrown upon them, which belongs to the liver. 
There is pain in the right side and under the shoulder blade; a bad 
taste in the mouth in the morning and a sense of weight and fullness 
about the liver and stomach, especially after eating. The counte- 
nance is pale, yellow and anxious. There is a gnawing sensation in 
the stomach and frequently a morbid craving appetite. The food 
does not nourish; the patient loses flesh, has dizzy spells and broods 
over his sickness. 

TREATMENT. 

The diet must be light, cathartics used to regulate the bowels, 
pepsin to aid digestion and tonics to brace up the system. If in 
a malarious district, anti-periodics must be employed. Tobacco 
must be given up and all organic or functional disorders removed. 
Catarrhal dyspepsia must be treated with astringents. 

There are many disorders of the stomach which receive the name 
of dyspepsia, but which are due to nervous sympathy with distant 
organs. These may be traced to brain and kidney disorders in 
the male and the kidney and womb diseases in the female. The 
proper treatment of the organ at fault will remove all disturbance at 
the stomach. To attempt to give a treatment for every variety of 
dyspepsia in a book of this nature would occupy too much space. 
A volume might be written on this subject alone. The case, in all 
its particulars, should be presented to a competent physician. 

Pyrosis is a name given to a symptom of dyspepsia. It consists of 



486 MEDICAL PRACTICE. 

a sensation of heat and burning in the stomach and the raising of 
sour and acrid fluid, -which scalds as it rises. The patient com- 
plains of sour stomach. The heat and pain are popularly described 
by the term heart-burn (Cardialgia) or water-brash when the saliva of 
the mouth flows freely. The sulphite of soda in five grain doses 
before each meal or small (less than half teaspoonful) doses of cal- 
cined magnesia will relieve. 

Goneness. This is a common term used to express a peculiar * 
sensation located about the pit of the stomach or just beneath the 
breast bone, because of its resemblance to fainting, hunger or empty 
stomach. In all cases it indicates a lack of tone in the nervous sys- 
tem or what is the same thing, a deficiency of nervous force, accom- 
panied with dyspepsia. 

Ulcer op the Stomach. — Gastinc Ulcer. 

The symptoms of this ulcer are the same as those of chronic in- 
flammation of the stomach or "dyspepsia." Food causes pain and 
a hearty meal distresses and provokes vomiting. The aliment taken 
is imperfectly digested, the face is pale and anxious, and there is a 
burning spot at the pit of the stomach that does not move and which 
hurts upon pressure. Gastric ulcer may last for years, or destroy life 
in a few weeks by perforation of the stomach or by opening blood- 
vessels and causing fatal hemorrhage. 

treatment. 

The food should be starchy, and when albuminous articles such as 
meat, milk, etc., are used, ihey should be first treated to pepsin and 
partially digested artificially, before swallowing. Our reliance for 
medication is placed chiefly upon golden-seal in decoction and pow- 
der; an opium pill at night, il necessary. 

Cancer op the Stomach. — Gastric Cancer. 

Gastric ulcer is rare, but cancer of the stomach is more common, 



HICCOUGH. 487 

and, we are sorry to add, more fatal. Both are seated near the out- 
let of the stomach. Cancer begins as gastritis, develops as ulcer, 
but in time there is the hard tumor in the upper abdomen, which can 
be felt through its walls. The shooting: pains, the hemorrhage, pro- 
longed constipation, the offensive odor of the breath and vomited 
matter, and the pale-yellowish cast of countenance, will further con- 
firm any doubts or suspicions of the presence of this fatal compiaint, 
whose existence is limited to a twelve-month. 

Hemorrhage of the Stomach.— See Consumption, page 463. 
Hiccough. — Singultus. 

Every one is familiar with this affection, which occurs after a hearty 
meal, particularly when fluids have been taken in great quantity and 
the person attempts to walk fast or otherwise exercise immediately 
after such a meal. Wind and acidity may provoke it. In infants, 
hiccough follows jolting or rough handling when recently nursed. 
Repeated attacks are likely to happen the same day from the least 
provocation. A child may be made to laugh until it hiccoughs. It 
occurs in fevers, strangulated hernia, and other grave diseases, and 
is in some a symptom of approaching dissolution. 

TREATMENT. 

When arising from simple causes, it usually terminates of its own 
accord. It is only when obstinate that relief is called for. Perfect 
quiet for a few moments may be all that is necessary. An unex- 
pected slap on the back or other surprise may stop it. Holding the 
breath as long as possible and then breathing very slowly, is a com- 
mon practice. Lemon juice is beneficial. If persistent, boil a tea- 
spoonful of flour of mustard in half a pint of water for ten min- 
utes, filter and take at one draught. 



488 MEDICAL PRACTICE. 

Inflammation of the Liver. — Hepatitis. 

This disease is more common in hot climates, but is occasionally 
met in northern latitudes as a result of injury, blows, etc. It is recog- 
nized by weight and pain to the right of the pit of the stomach. The 
part is tender and pain increases upon pressure. Pain under the 
right shoulder-blade is complaint d of and the subject cannot lay on 
the left side. The liver is congested and enlarged, the tongue is 
coated, there is a bitter taste in the mouth, with nausea and vomiting 
perhaps. The skin is sallow and yellowish, jaundiced. The urine is 
also colored and stains the linen yellow. The excrement is wanting 
in color, is clay or lead-like. Some of these symptoms, such as head- 
ache, nausea or vomiting and sallow complexion, are popularl} r known 
as biliousness, and many times the bile has nothing to do with it. 
Some people, and doctors among them, always see a "liver out of 
order," and consequently the poor bowels are punished with cathar- 
tics, often harsh, irritating and drastic. We would not mention it 
only that in too many cases the requirements are of a sustaining, 
rather than a depleting, treatment. In hepatitis we sometimes have a 
high fever. When ihe inflammation involves one of the principal 
veins (portal), the jaundice is intense and the dejections completely 
discolored. The results of inflammation of the liver are numerous; 
abscesses, tubercles, calculi or stones, etc. In hot climates, abscess 
is most common. The symptoms of abscess are the same as abscess 
in any other place, chill, fever, etc. It may "point" and discharge 
in any direction. 

TREATMENT. 

In the majority of instances the condition at the outset is one of 
congestion simply. If the bowels are constipated or have been inact- 
ive, give for two or three evenings a teaspoonful of calcined magne- 
sia in sweetened water or milk. Only in an aggravated case would 
wc give repea'ed doses of leptandrin or of the 



JAUNDICE. 489 

$.— Podophyllin, two grains, 

Cream of Tartar, .... two drams. 

Mix. 

When this is necessary, it may be divided into four powders, and 
one given in syrup nightly. The spirit vapor bath is necessary and 
almost invaluable. The internal remedies are 

I?.— Tinct. of Veratrum Viride, . . fifty drops, 

Essence of Wintergreen, . . one dram, si 

Water, two ounces. 

Mix. 

Take ateaspoonful every two or four hours according to the fever. 
Also 

I£. — Tincture of Nux Vomica, . . twenty drops, 

Water, two ounces. 

Mix. 
Take a teaspoonful every hour or two hours after a dose of the 
above recipe. 

Upon recovery from the violence of the acute attack and as long 
as the sallowness continues, or the residence, occupation and diet 
remain the same, the only safeguard against its repetition or some 
form of intermittent, lies in the occasional use of a pill made of 

]$. — Podophyllin, . . . six grains, 
Leptandrin, . . . twelve grains, 

Iridin, .... two grains, 

Extract of Teraxicum, q. s., to make twenty-four pills. 

Jaundice, Jandehs, Yellows. — Icterus. 

The prominent feature of jaundice is the yellow color of the skin 
and eyes. This color is not exact in shade in different individuals, 
frequently comes close to black or green. The patient is depressed, 
low spirited, the excrement is deficient in bile or in color, and the 
urine is high-colored, yellowish. The bile which should pass along 
the intestines may be held back and thus forced into the blood, or it 
21* 



490 MEDICAL PRACTICE. 

may, on account of the condition of the bowels, be reabsorbed. It 
is evident, therefore, that icterus is not so much a disease as a symp- 
tom of disease. 

TREATMENT. 

If the cause can be discovered treat accordingly. The custom 
among nurses of treating infants with saffron tea is certainly worthy 
of imitation. In the adult an emetic of lobelia will sometimes break 
up an acute jaundice at once, or the condition upon which it de- 
pends. A course of treatment generally applicable will be the pill 
just given above, and the spirit vapor bath. 

Acute or Yellow Atrophy of the Liver. 

We may have jaundice, followed quickly by the vomiting and 
purging of blood, severe headache, delirium, and, from the blood- 
poisoning by biliary matters, coma and death. This is the history of 
the disease under consideration. It runs its course rapidly, and as 
it is generally fatal, it may be well to note its differentiation. 

It is distinguished from inflammation of the liver by the jaundice 
being more marked, by the hemorrhage and coma; there are chemi- 
cal tests also. The disease belongs to those whose constitution is 
debilitated by intemperance, venery or malaria. 

Hobnailed, Nutmeg, Gm or Granular Liver. 
Cirrhosis Hepatis. 

This pathological condition is called hobnailed on account of the 
lumps upon the surface of the liver, which can be felt through the 
skin; gin-liver because more common with the intemperate; nutmeg 
and granular from its feeling and appearance upon dissection. In 
this disease there is atrophy or diminution in size, but the biliary 
ducts are dilated. It begins as hepatitis, but developes abdominal 
dropsy. The dropsy may be the only symptom present, and may 
mislead, or its presence may prevent an accurate examination of the 
liver. There is great loss of flesh and strength, vomiting and purg- 
ing blood, and finally coma from blood-poisoning. It results from 



GKAVEL. 491 

intemperance, and its amelioration must begin in a reform of such 
habits ; then the management of the dropsy and the use of bitters 
and tonics. 

Other Diseases of the Liver. 

In the scrofulous, syphilitic, debilitated and intemperate we occa- 
. sionally meet with an enlargement of this organ. In fatty degenera- 
tion of t7ie liver the surface is smooth, and there is dropsy, In waxy 
liver the increase in size is greater and the organ is harder; dropsy 
does not always follow. It occurs in the syphilitic most often. In 
cancer of the liver the symptoms are the same as those of chronic in- 
flammation of the liver, with, perhaps, the exception of less jaun- 
dice. The enlargement is greater and more rapid than in either of 
the above, the dropsy is less or wanting, the spleen is normal in size, 
and the pain is greater. There is a rapid loss of flesh and strength, 
and the party wears the worried and anxious look of those afflicted 
with cancer. 

Stone, Gravel, Gall- Stones— Calculus.. 

Stones are formed from the deposit of impurities, very minute at 
first, but which increase in size by successive layers upon their sur- 
face. It is similar to the massive balls of snow formed by school- 
boys, but differs in one respect, instead of the ball going to the snow, 
the snow seeks the nucleus. They are chemical formations, and may 
arise from an excess of acid, of alkali, of ammonia, etc. They are 
minute, may be single or multiple, and sometimes in the bladder 
reach the extensive proportions of a goose egg. They are found in 
the kidneys, in the bladder, in the urethra, in the gall-bladder, and 
in the intestine \ 

Calculi (renal), or stones in the kidneys, are difficult to detect, and 
in most instances soon leave their place of formation and pass along 
the ureters, to be deposited in the bladder. The symptoms are pain 
in the small of the back in the region of the kidneys, with hema- 
turia or bloody urine ; and if they do not progress, purulent matter 
and destruction of tissue. They are usually first discovered in their 



492 MEDICAL PRACTICE. 

progress downward. The pain comes suddenly, is very severe, and 
as suddenly departs. It begins with the entrance of the stone into 
the ureter, and ends with its exit from the tube. With this is pain 
along the groin and down into the testicles, which are spasmodically 
drawn upward. The treatment consists in thoroughly relaxing the 
•whole system so as to promote relaxation of the tubes through which 
the calculus passes. Patients should be put to bed, and teaspoonful 
doses of gelseminum given every twenty or thirty minutes until it is 
impossible to raise the eye-lids. The passage is then speedy and unac- 
companied with spasm; besides, if others are forming, they will be 
loosened and carried toward the bladder. Morphine in one-quarter 
grain doses may be administered every two hours to relieve pain, or 
the physician may use chloroform by inhalation. 

Stone in the bladder, particularly if it reaches any size, is usually 
single. In females the shorter and larger urethra facilitates their 
expulsion when small. From the weight upon the neck of the blad- 
der we have irritation of this part. The result is, the frequent desire 
to pass water; and while it is passing the stone covers the mouth of 
the discharging pipe, and the urine is retained. The flow is some- 
times speedily renewed by changing the position of the body. This 
irritation may continue for years, and may be the sole cause of com- 
plaint, except, perhaps, the sensation of weight or dragging down- 
ward. The physician has a simple test by which he can remove all 
doubt as to the presence of stone in the bladder. A catheter (solid) 
is passed along the urethra into the bladder, and is so manipulated 
that if a stone is present the ear easily detects the metallic sound 
caused by their striking together. 

TREATMENT. 

Efforts to dissolve a stone by chemicals have been uniformly un- 
successful. An instrument has in latter years been manufactured 
which will crush the calculus between its jaws. Experience has 
proved that is not as valuable as it would be supposed. Theie is 
great difficulty in pulverizing the mass, and the removal of the pieces 
greatly injures the urethra, by cutting and tearing. Surgery must 



GALL-STONES. 493 

be called into service, and if properly employed but little injury need 
be done and the number of successful operations reach a higher per- 
centage than is currently reported. 

Stones in the the urethra are smaller particles which have been 
forced from the bladder by the urine. They should be returned by 
warm water injections and the calibre of the tube increased by dilata- 
tion. In this and the conditions above noticed the use of remedies 
to increase the quantity of urine should be carefully avoided, par- 
ticularly turpentine, copaiba and similar irritants. 

Gall-stones. As the name implies, these form in the gall-bladder 
and passing along a short tube empty into the intestine. Here the 
pain is in the upper abdomen near the liver and stomach. It also 
begins and suddenly terminates; the pain is severe and may be mis- 
taken for colic. There is this difference: in gall-stones the pain is 
always at one point and is much relieved by pressure. The counte- 
nance is yellowish, and there is nausea or vomiting, and the presence 
of gall-stones in the evacuations from the bowels. With the excep- 
tion of the latter symptom, the disorder closely resembles neuralgia 
of the liver and bilious colic. Until it is definitely known that there 
are gall-stones the treatment should be the same as in bilious colic. 
When it is fully determined, the second attack should be treated 
with the administration of teaspoonful doses of gelseminum every 
twenty minutes until the system is fully relaxed and until the eyelids 
are only raised with difficulty. One-eighth or one-quarter grain 
doses of morphine may be given to relieve pain. 

Splenitis. 

Inflammation of the spleen is not frequently met as a circum- 
scribed disease. When it does occur, it is detected chiefly by the 
soreness and pain upon pressure on the left side under the false or 
short ribs and above and to the front of the kidneys. There is a 
sense of weight, uneasiness upon lying upon that side and feverish- 
ness; nausea and vomiting sometimes. It is a disease of the hot 



494 MEDICAL PRACTICE. 

climates and will yield to cathartics bringing away copious watery 
discharges. We prefer 

1$. — Podophyllin, , two grains, 

Cream of Tartar, .... two drams. 

Mix. 

Divide into four powders and give one iu syrup every two hours 
until operation. 

The enlargement of the spleen is very common, occurring in fever 
and ague, typhoid and all malarial fevers, and in leucocythaemia. 
It is sometimes distended to great size by these agues. When the 
enlargement becomes permanent it is termed "ague cake." Then 
we have disturbances in the abdominal organs such as would result 
from the presence of a tumor. The stomach is irritable and may 
throw off food, the liver and bowels inactive, face sallow and tongue 
coated, and we may have abscess of the spleen. 

TREATMENT. 

In malarious districts there is scarcely a person who is subject to 
chills and fever, who has not an enlarged spleen. Occurring during 
the fever it yields to remedies that remove or cure the fever. This 
is less effectually done with each recurrence of the intermittent. 
Hence after an acute attack it is best to use for some time after, pills 
made of 

I£. — Podophyllin, six grains, 

Leptandrin, twelve grains, 

Iridin, two grains, 

Extract of Dandelion, . . . sufficient quantity. 
Mix, and make twenty-four pills. Take one each night and morn- 
ing. We have in another place also recommended this pill to pre- 
vent an attack or recurrence of ague. In case of enlargement of 
longstanding, this will not avail; generally quinine has been used 
and used to excess, and other remedies must be employed. A regu- 
lar course of medicine is necessary and the more nearly it is adapted 
to the condition of the individual, the better. 



INFLAMED BOWELS. 495 

Inflammation of the Bowels. — Enteritis. 

The intestines are lined with a mucous membrane and covered 
with a serous coat called peritoneum. An inflammation of the mucous 
coat gives rise to such conditions as discussed under the titles of 
diarrhoea and dysentery. To the peritoneal inflammation we will 
shortly give attention. Enteritis proper is an inflammation involv- 
ing both surfaces and the intermediate tissues. Medical men limit 
the term to the small intestines, that of the larger being classed 
as rectitis, colitis, etc. The symptoms of enteritis are acute and 
constant pain in the abdomen usually about the naval, aggravated at 
intervals, tenderness upon pressure, chill sometimes, high fever and 
great thirst. There is loss of appetite, nausea and vomiting per- 
haps. The passages from the bowels vary; may be mucoid, offensive 
or bloody, or constipation may be present. The most alarming 
cases are those which result from obstructions in the bowels, when 
labored breathing, bloating of the abdomen, hiccough, exhaustion 
and death may follow. 

It is distinguished from colic by the tenderness of the abdomen and 
the increased pain on pressure, both absent in colic. A colic long 
continued may result in enteritis. From typhoid fever by the brain 
symptoms. From peritonitis by its local pain and tenderness, more 
diffused in peritonitis and by the nausea. 

TREATMENT. 

If the cause is unknown, a careful examination must be made for 
hernia or other obstructions. If any one of these are found, it 
should be treated as advised under that heading (see Obstructions in 
the Bowels.) In general, it will be b'tter to begin treatment by a 
mild cathartic; we prefer two doses of calcined magnesia, a tea- 
spoonful each in a little milk, three hours apart. This relieves the 
intestines of all irritating contents. For the pain give 

I£. — Tincture of Nux Vomica, . . twenty drops, 

Water, a cupful. 

Mix. 



496 MEDICAL PRACTICE. 

Dose, a teaspoonful every two hours. For the fever and inflam- 
mation: 

1$. — Tincture of Yeratrum Viride, . . one dram, 
Essence of Wintergreen, . . . one dram, 

Water, a cupful. 

Mix. 
Give a teaspoonful one hour after each dose of the above. A few 
thicknesses of flannel wrung out of hot water and sprinkled with 
spirits of camphor may be, if its weight can be borne, placed over 
the abdomen. If it cannot, a spirit vapor bath is advisable, by the 
rubber bag laid between the knees. If necessary, an opium pill may 
be administered at bed time. 

Peritonitis. 

This is more dangerous and more frequently fatal than enteritis, 
which it closel}' resembles. The prominent symptoms are extensive 
and severe pain in the abdomen and tenderness, the former increased 
by the slightest motion or pressure, and its distention by gas, and 
afterward also by fluids. There are throbbing headache, great 
thirst, nausea and vomiting sometimes, high fever, with wiry rapid 
pulse, dry skin, and a short respiration, limited to prevent disturb- 
ance of the bowels, and hence increase of pain. The course is rapid, 
and in a few days the distention of the abdomen has reached its ex- 
treme limits, and dissolution succeeds delirium and coma. Peritoni- 
tis not unfrequently follows upon delivery and abortion, but may 
originate in injuries or exposure, or the effects of other diseases, as 
in the perforation of the bowels in typhoid fever, or of the stomach 
in ulcer, etc. In these latter cases collapse is precipitate and inevi- 
table. 

It is distinr/ xixlied from puerperal fever by the latter occurring sub- 
sequent to childbirth, the cessation of the uterine flow; puerperal 
fever includes peritonitis. It is more extensive than enteritis, and 
the bloating is greater; enteritis is partially a peritonitis. The dif- 



COLIC. 497 

ference between the two is not always well marked, and the treat- 
ment is about the same. In colic there is no fever or tenderness, 
and the pain is not constant. 

TREATMENT. 

We begin with an examination for obstructions of the bowels, and 
if discovered or strongly suspected, we treat accordingly (see Ob- 
structions of the Bowels.) In case of recent labor, we treat as puer- 
peral fever. If it is a clear case of peritonitis, the treatment must 
be active. A teaspoonf ul of calcined magnesia is given in sweetened 
water or milk every three hours until free watery evacuations. Only 
in the first stage do cathartics seem admissible ; but such a mild and 
unirritating one as we have indicated may be repeated subsequently, 
sufficiently often, to keep the bowels moving regularly, or nearly so. 
To control the inflammation, we rely chiefly upon the veratrum and 
vapor sweat. Rubber bags or bottles are filled with hot water, and, 
being covered with flannel and wetted with alcohol, are placed at 
the sides by the hips. Veratrum viride is given in doses regulated 
in size and frequency by the pulse. Three-drop doses in a little water 
might be given every hour at first; when the pulse falls to eighty, 
give every two hours. If it continues over a hundred, increase to 
five drops, and continue until the pulse begins to fall or nausea su- 
pervenes, when it falls rapidly. If the pulse can be held at eighty 
for twenty-four hours, all danger has passed. 

Colic, Belly-ache. 

This is not so much a disease as a symptom of some derangement 
of the stomach or bowels with pain. The treatment is therefore con- 
fined to the relief of the pain. The pains are sharp and occasional, 
may be in any part of the bowels, but mostly around the navel. 
There may be nausea, vomiting, bloating from wind, some tenderness, 
cramping of the muscles into hard knots or cold sweats; more than 
one of these symptoms being present in every attack. Infantile colic 
or griping is produced by wind, indigestion or improper and indiges- 
tible food. Flatulent or wind-colic in adults is of the same nature, the 



498 . MEDICAL PRACTICE. 

wind sometimes accumulating so as to greatly disturb the abdomen 
and is accompanied with a rumbling noise. Bilious colic depends 
upon the presence of bile in large quantities. It regurgitates into the 
stomach, causing heat and a burning sensation and vomiting of a yel- 
low or greenish matter. Painter's colic is confined to this and other 
crafts and arises from the absorption into the system of the lead used 
in painting, gilding, etc., or the same metal handled where mined or 
manufactured, (see below). Iliac passion or ilius is a species of colic 
due to obstructions in the bowels. Vomiting is always present and 
the constipation is obstinate (see Obstructions in the Bowels). The 
presence of worms in children may lead to colic, also freight or ex- 
cessive emotion in those of delicate habit. 

It is distinguished from some diseases without difficulty; from others 
not as readily from the fact stated at the commencement of this arti- 
cle. Infantile colic is fortunately caused, in the majority of cases, 
by wind. Flatulent colic is accompanied with the passage of wind 
by the mouth and rectum. In the pain of dysmenorrhcea there is the 
menstrual flow. In inflammation of the bowels there is the fever 
and pain on pressure, though colic mny result in inflammation. In neu- 
ralgia vomiting and knotting are absent. The passage of stone from 
the kidney creates pain in the loins, and the testicle is drawn up. 
The difference between bilious colic and the passage of gall stones is 
so slight as to annoy the physician. Their presence in the dejections 
is the only certainty of the latter. 

TREATMENT. 

The infantile colic may be met by a tea of spearmint, or chamomile, 
a half-ounce to a pint of boiling water, or by the tincture of either, 
ten drops to a half-tumbler of water. Dose, a half-teaspoonf ul every 
one or two hours. Ten or fifteen grains of calcined magnesia may 
be given in water. The interval between each nursing should be 
lengthened. 

In flatulent colic in adults give teaspoonful doses every half-hour, 
until pain is mitigated, of 



COLIC. 499 

I£.— Fluid extract of Khubarb, . , . one dram, 

Brandy, two drams, 

Essence Spearmint, . . , , . thirty drops, 
Bicarbonate of Soda, . , . . one dram, 

Simple Syrup, four ounces. 

Mix. 
Apply hot packs to the abdomen. Hot water injections act kindly. 
Bilious colic may be treated in a similar way. The medicine 
should be repeated in case it is lost by vomiting. The cholera tinc- 
ture is better. The prescription is 
I£. — Tincture of Opium, 
Tincture of Camphor, 
Tincture of Capsicum, , , of each, one ounce, 

Chloroform, three drams, 

Alcohol, to make .... five ounces in all. 

Mix. 
Dose, a teaspoonful every hour in a little water, or 

I£. — Chloroform, one dram, 

Comp. Spirits of Lavender, . . one ounce. 

Mix. 
Give a teaspoonful every fifteen minutes in a little water. When 
vomiting is obstinate, it may be relieved by copious injections of hot 
water by the rectum, and the application of the mustard paste over 
the stomach. To get the full effects of the mustard, mix with cold 
water. In most colics there is pain about the naval. When this is 
present the disease may be cured by giving alone, 

1$. — Tincture of Nux Vomica, . . . thirty drops, 

Water, four ounces. 

Mix. 
Dose, a teaspoonful every half-hour. For a child, double the 
quantity of water. 

In protracted and obstiDate colic chloroform should be adminis- 
tered. Pour a half or whole teaspoonful upon the centre of a folded 



500 MEDICAL PRACTICE. 

napkin and place an inch or two from the nose so that plenty of air 
may be inhaled with the vapor. In ilius, treatment should only fol- 
low a careful examination of the abdomen. Hernial or other obstruc- 
tions may be present. The reader is referred to the pages upon ob- 
structions in the essay on constipation. If none of these maladies 
exist, the case may be treated as one of colic and impaction. Admin- 
ister the chloroform and lavender compound as mentioned above, 
and in addition, 

~Bf. — Calcined Magnesia, .... one teaspoonful, 
Milk or Sweetened water, . . . one ounce. 

Mix. 

Repeat every hour until free evacuations take place. 

Lead or Painter's Colic. — Colica Pictonum. 

As above remarked, this disease follows the introduction of lead 
into the system. This takes place by absorption through the skin or 
by inhalation of fine dust. It prevails among painters glaziers, 
plumbers, printers, type-founders, white-lead manufacturers and lead 
miners. It comes on gradually and presents all of the symptoms of 
lead poisoning. There is a bluish line around the margin of the 
gums, the wrists frequently and suddenly give out or drop from par- 
tial paralysis, the appetite is poor and digestion imperfect. The 
bowels are also partly paralyzed by the lead and constipation is 
common. The evacuations resemble those of sheep and are light- 
colored. There is general emaciation and paralysis of the lower 
limbs is a common sequeL The colic comes on with darting pains 
which increase in severity. The attack resembles bilious colic. It 
is more protracted and may last two or three days, unless cured. 

TREATMENT. 

The remedies employed during the colic are about the same as pre- 
scribed for bilious colic. We prefer the chloroform and lavender 
compound, a teaspoonful in water every hour or h;Uf hour; a half 
hour after each dose a teaspoonful of the mix vomica and water 



SUMMER COMPLAINT. 501 

recipe; hot packs, or, better still, hot baths of the whole person, or 
the spirit vapor bath. When the stomach quiets, give the calcined 
magnesia and water, a teaspoonful of each every two hours, till the 
bowels move. 

Returning to the same trade is likely to provoke another attack. 
Prevention is, therefore, necessary. This is accomplished by keep- 
ing the system free from lead. The anti-dust respirator should be 
worn to intercept the metal in inhalation. A paper cap will keep it 
from the hair of the head. Careful and thorough washing, using a 
nail-brush for the fingers, prevents its introduction while eating. 
Change the clothes when working hours are over. The sulphur 
bath will take it from the skin, and the internal use of sulphite of 
soda in three or five grain dos s three times a day, 'will tend to elimi- 
nate any traces in the body. We are informed that the free use of 
milk will prevent lead poisoning, but we have not been able to verify 
the statement. It may be good, is simple and easily tried. 

Summer Complaint. — Cholera Infantum. 

This is the most fatal disease among children in cities during the 
summer, and it is not to be wondered at when we consider the food, 
the air, the filth; such food, such stench; such surroundings. Among 
the well-to-do the babe is nursed too frequently and irregularly, or the 
whole care is thrown upon the nurse-girl, who takes little heed of the 
condition of its bottle and less of the character of its contents. Be- 
sides, we believe the majority of infants are too warmly clothed; for 
fear they will take cold, they are almost baked. In comparison with 
other animals, the hunr.au family show in its young a dreadful mor- 
tality. 

Infantile cholera accompanies dentition. The diarrhoea first ap- 
pears and may be slight or profuse. The discharges are thin and 
light-colored or greenish, seldom yellowish. They soon increase in 
frequency add become frothy and offensive. The stomach is irri- 
table, with nausea and vomiting. Soon follows constant vomiting 



508 MEDICAL PRACTICE. 

and purging, with great loss of flesh and strength. Fever and thirst 
are great, pulse rapid, skin diy, head and abdomen hot, extremities 
cold. The face becomes thin and pale, the eyes sunken, the child 
restless, dull and drowsy, or delirious. With dark offensive evacua- 
tions, cold surface, bloated bowels and insensibility, the fatal termi- 
nation approaches. 

The indications are to change the acrid character of the evacuations, 
quiet the stomach, stop the fever, restore normal circulation, subdue 
irritations, and supply nourishment. 

TREATMENT. 

A decoction made from 

IJ. — Peppermint, . ... . one dram, 

Khubarb, pulverized, . . . two drams, 

Bicarbonate of Potash or Soda, . four drams, 

Hot water, . . . one-half pint, 

And when cool, 

Brandy, . . ... one ounce. 

Mix. 

Should be administered in teaspoonful doses every ten, twenty, or 
thirty minutes until the bowels move with a golden or yellowish 
stool ; then three times a day. If the vomiting is persistent and this 
cannot be held upon the stomach, apply a mint poultice over the 
stomach, or a paste of ground ginger, removing it when the surface 
becomes reddened, reapplying when the color fades. If the child 
can swallow them, give small bits of ice, or administer teaspoonful 
doses every half hour of the following : 

$.— Tincture of Nux Vomica, . . twenty drops, 

Water, four ounces. 

Mix. 

If the discharges are of a light color, give ten drops of the fluid 
extract of leptandria, in a teaspoonful of simple syrup, every two 
hours, until they become of a dark-green color, then proceed as 
above. 



CHOLERA MORBUS. 503 

The remedy for the disease and its fever is ipecac. Take 

3$. — Tincture of Ipecac, . . twenty to thirty drops, 

Water, four ounces, (a cupful.) 

Mix. 

Give a teaspoonful every one, two or three hours, according to the 
urgency of the symptoms. It may be given every two hours, alter- 
nating with any other remedy needed. 

Some physicians advise the use of cold water for drink, given in 
small quantities, often repeated. "We prefer hot water, in every cupful 
of which has been dissolved two drams of pure gum arabic. If not 
weaned, give the breast exclusively, and have the mother follow sim- 
ple dh t. If using the nursing bottle, give the fresh milk of a healthy 
cow, to which is added lime-water, one dram to a cupful. If you can- 
not be sure about the cow, use fresh condensed milk, one part to warm 
water thirty parts. That put up in cans is sufficiently sweetened. 

If the head or abdomen is hot apply cold packs; if the feet are 
cold use the hot water bag. Pure air and a uniform temperature are 
desirable. If you cannot get pure air any other way, go to the 
country — it may be the child's salvation. 

No opium, in any form, we beg of you. Remember our words — 
after opium, the coffin. 

If the gums are reddened, hot and swollen, lance them as elsewhere 
described. 

Cholera Morbus. 

This is a disease of hot climates or of temperate climates during 
hot weather. Carelessness in drinking or eating may bring on an 
attack at any season. This disorder may be placed between colic 
and cholera. There are darting pains through the bowels and some- 
times cramps, or a slight diarrhoea may be the only premonitory 
symptom. Bile in considerable quantities flows into the intestine 
and stomach, when nausea, vomiting and purging follow. In severe 
cases these symptoms may develop simultaneously. The surface is 



504 MEDICAL PRACTICE. 

generally cool, the pulse weak, and the thirst excessive. Griping is 
intermittent but severe, the limbs draw up, the abdomen recedes and 
the subject shrieks or groans with pain. As in all painful affec- 
tions of the bowels, there is much prostration of strength. 

It is distinguished from colic by the purging; in colic the bowels 
are usually constipated; from inflammation of the stomach by the 
feveri^hness, and from cholera as described below. 

TREATMENT. 

What the patient asks for and wants above all things etee is relief 

from pain. Sometimes this may be most easily effected by an 

emetic, made of tincture of lobelia, one dram, and warm water one 

ounce. But we are wise in our generation and do not want emetics. 

A simple and effective remedy is hot water. Drink of it frequently, 

inject into the bowels and apply hot packs to the abdomen. The 

hot packs mny be sprinkled with spirits of camphor and should 

be frequently renewed. The anti-spasmodic compound meets the 

indication. 

I}. — Chloroform, one dram, 

Comp. Spirits of Lavender, . . one ounce. 

Mix. 

Give a teaspoonful every fifteen minutes, or oftener if required. 
We prefer the cholera tincture when it is at hand. As this meets 
t promptly most of the summer complaints, the diarrhoeas, colics and 
choleras, a vial of it should be found in every household. It is com- 
posed of 

1$ — Tincture of Opium, 
Tincture of Camphor, 
Tincture of Capsicum, of each, one ounce, 
Chloroform, . . . three drams. 

Alcohol, enough to make five ounces in all. 

Mix. 

Give from twenty to sixty drops clear, or in a little water. 



RUPTURES. 505 

HERNIA. 

There arc several kinds of hernia, named from their location or 
the part of t e body involved. They occur usually in persons of 
weak constitutions, but not always, as many of the more robust are 
afflicted with rupture. Sometimes there is a local weakness which 
is not known to exist until the accident occurs. Ventral rupture is 
simply i he protrusion of a portion of the intestines or other part of 
the abdominal contents through the abdominal walls. It occurs 
more frequently in men while over-straining and lifting, and in 
women while in labor. The most common form is inguinal. The 
intestine passes in tbe line and in the canal of the spermatic cord. A 
lump is discovered near the pubic bone, which disappears upon lying 
upon tbe back and drawing up the knee. Sometimes some little 
manipulation may be necessary in order to return it. Without proper 
appliances, in the shape of a comfortable and well-fitting truss,* the 
rupture is likely to become more extensive and aggravated, and there 
is clanger of strangulation. Strangulation is simply a condition in 
which it is impossible from constrictions above to return the en- 
cased knuckle [tor treatment of inguinal strangulation see Hernial 
Obstructions] When the protrusion passes down so far as to reach 
the scrotum it is termed scrotal hernia. This is dangerous in the ex- 
treme and is the most frequent kind of irreducible hernia. Umbilical 
hernia is a protrusion or rupture through the naval and occurs prin- 
cipally in infants and is caused by crying. The treatment is simple. 
Having returned the contents of the hernia, a puce of adhesive 
plaster two inches wide and six inches long is fastened to the abdo- 
men, in this manner; one-half is stuck to the skin on a line directly 
across the body, with the centre of the plaster immediately over the 
navel. The hernia having been returned and the surface skin 
folded inward and held between the finger and thumb of one hand, 
the plaster is drawn tightly and the other end fastened. The plaster 
is now smooth from end to end and also the skin underneath, except 

* See Medical, Appliances. 

22 



506 MEDICAL PRACTICE. 

at the centre, where there is a fullness of skin but no protrusion. 
Over this centre a pad may be placed. The safety-pad made of 
several thicknesses of fine linen, to protect the skin from being 
injured by pins may be extended downward to cover the plaster if 
preferred. A band around the body is required to secure the pad in 
its position. If the cord has not yet separated it may be necessary 
to remove the adhesive strips daily, otherwise it may remain for 
weeks. 

Femoral Hernia occurs more frequently in the female, but is occa- 
sionally met with in the male. It does not take the slanting course 
in the groin, as in the inguinal form, and passes more directly down- 
ward upon the front and inner aspect of the thigh. It is small and 
roundish, like a marble or nut. A truss is required to retain the 
part in its proper place. 

Purging, Looseness op the Bowels. — Diarrhan. 

This is a disease of the intestines where the evacuations are too 
frequent, too liquid and too copious. It comes from nervous shock 
as to soldiers in battle, sea captains in storms, from sympathetic irrita- 
tion aa in teething, irritation of the brain, from aphthous mouth by 
spreading to the stomach and bowels, from colds, improper food or 
drink, mo-bid biliary secretions, from want of tone, from irritation, 
ulceration, etc. 

TREATMENT. 

For the management in ca-es of teething, see Dentition; ii aph- 
thous mouth see Aphthae; in typhoid fever, see remarks under that 
heading. For a child take a teaspoonful of equal parts of pulverized 
rhubarb, hi carbonate of soda and peppermint plant, mixed to- 
gether and add a teacupful of boiling water; when cool, sweeten and 
give in teaspoonful doses, or 

1$. — Fluid Extract of Rhubarb, . . . one dram, 

Brandy, two drams, 

Essence of Spearmint thirty drops, 

Bicarbonate of Soda one dram, 

"Water or Simple Syrup, . . . four ounces. Mix. 






J 



DIARRHOEA. 507 

Give a teaspoonful in the morning every hour until the bowels 
move a bright yellow, then stop. After this give every hour during 
the clay a teaspoonful of the tea of red raspberry leaves. Keep the 
child quiet. Walking with it and moving about keeps up the irrita- 
tion in the bowels ; also 

3$. — Kino, . . . . . . two grains, 

Pulverized Opium, .... one grain, 

Leptandrin, two grains, 

Pulverized Licorice, . . . one grain. 

Mix. 
For a child two or three years of age make six powders and give 
one at time of rest in brown sugar and a little water, repeating if the 
discharges recur during the night. If the child sleeps do not disturb 
it. The next morning give a single dose of the rhubarb compound 
and follow with the raspberry tea during the day and a powder at 
night. 

Many of the diarrhoeas of children are from indigestible food. 
When this is known to be the case three to five grain doses of pepsin 
three times a day will assist digestion and stop the evacuations. 
Fermentation may be suspected when the bowels bloat with wind, 
whrn gas is raised from the stomach and the vomiting and excre- 
ment are acid. In such a case 

I£. — A Solution of Gum Arabic, . one ounce, 

Carbolic Acid, . . , . one to three grains. 

Mix. 
Give a teaspoonful every hour or two. 

For the adult use the rhubarb compound in teaspoonful doses every 
two hours. If possible keep quiet in bed, with a pillow under the 
hips. This puts the burden of breathing entirely upon the chest and 
leaves the abdominal contents undi turbed. At night use the kino 
in this way: 

1$. — Leptandrin and Kino, each . . four grains, 
Pulverized Opium and Licorice, each two grains. 

Mix. 
Make four pills. Take one at bed time, repeating if the bowels 



503 MEDICAL PRACTICE. 

move during the night. As the diarrhoea abates the pills may be 
continued at night and the rhubarb mixture given at longer 
intervals. 

In that form of diarrhoea attended with frequent and watery dis- 
charges a simple and effective remedy is 

I£. — Podopliyllin one grain, 

Hydrastin, fifteen grains, 

Sugar of Miik or Sugar, . . . thirty grains. 

Mix. 
After thorough mixing divide into thirty powders and take one 
every one or two hours. 

In the summer diarrhoeas attended with griping, colic or cholera 
morbus, take 

H,. — Tincture of Opium, 
Tincture of Camphor, 
Tinrture of Capsicum, of each, . one ounce, 

Chloroform, three drams, 

Alcohol, sufficient to make . . five ounces in all. 

Mix. 
Two or three doses will usually effect a cure. 

Dysentery, Flux, Bloody Flux. — Rettitis, Colitis. 

Dysentery differs from diarrhoea in two particulars; it is confined 
to the lower bowel and is attended with hemorrhage. A diarrhoea 
may extend along the whole tract of the int stines, but bleeding is« 
rare. It develops into the chronic form in th; hotter climates and 
but seldom in the temperate zone. There may be costiveness in dys- 
entery located above the inflammation, in which case remedies will 
not act. The liver is congested and the circulation blocked up, h nee 
the veins in the lower bowel are distended. Especially is this the 
case in malarial districts. The mucous membrane is relaxed ; there 
may be a catarrhal diarrhoea aud dysentery follow, or both may exist 



DYSENTERY. 509 

simultaneously. Ulceration is not uncommon. There is frequent, 
painful and fruitless attempts , to evacuate the bowels, pain in tiie 
rectum and tenderness of the abdomen upon pressure. 

TREATMENT. 

Rest is necessary in all diseases of the bowels and is an important 
element here. Begin the treatment with calcined magnesia one tea- 
spoonful in an ounce of sweetened water. If malarious or bilious, 

I£. — Podophyllin, , ... six grains, 

Leptandrin, . . . . twelve grains, 

Hydrastin, .... twelve grains, 

Extract of Conium, . . . eighteen grains. 

Mix. 

Make twelve pills and give one every hour until they operate. 
If the pain and desire to evacuate are severe and obstinate, place a 
pill of opium in the bowel with the suppository syringe, or inject 
twenty drops of laudanum with an equal amount of slippery-elm 
mucilage. Apply cloths wrung out of hot water and sprinkled with 
spirits of camphor, to the abdomen. 

1^. — Sulphate of Magnesia, . . . one dram, 
Ipecac, . four grains, 

Cinnamon, . .... two grains. 

Mix. 

Pulverize and make ten powders and give one in moistened brown 
sugar every three or four hours. At night give one of the following 
pills: 

I£. — Kino, four grains, 

Pulverized Opium, . . . two grains, 
Leptandrin, . four grains, 

Pulverized Licorice, . . . two grains. 

.Mix. 
Make four pills. 
If there is not improvement in two or three days 



510 MEDICAL PRACTICE. 

IV — Solution of Persulphate of Iron, . . one ounce, 
Warm water, . ... one pint. 

Mix. 
Strain thoroughly through cloth to avoid any irritating substance, 
and inject slowly into the rectum. If the whole can be introduced 
without shock or fainting, the better. Have the patient hold as long 
as possible. This ends the hemorrhage. It has saved life in our 
hands and we know will do so in the hands cf others. 

CONSTIPATION. 

Constipation or costiveness may be defined as irregular and tardy 
movements of the bowels. Another definition would be that the 
interval between each movement is protracted, or that, instead of an 
evacuation occurring every morning as is common with those in 
health, it may happen every other day or every third day. When 
constipation is habitual, the intervals not only vary but are some- 
times prolonged to one, two or three weeks. In this latter condition 
the excrement is hard, dry, and removed with such difficulty that it 
receives the name of impacted feces. Most d seases, particularly 
those that lower the tone of the nervous system, have constipation as 
a symptom. This symptom receives attention elsewhere in the treat- 
ment of each particular disease with which it is connected. Con- 
stipation in the healthy arises from two causes; diet ami habit. The 
experience of each person teaches them which articles of food are 
binding. No two are exactly alike. Commonly the excessive use of 
fine wheat flour in bread cr cake and a scarcity of the fluids, are the 
chief causes. The use of narcotics and stimulants have the same ten- 
dency. But we think the majority suffer from neglectful habits. 
The call of nature may be slight or imperative, but from some en- 
grossing labor or other trivi 1 affair that present- a plausible excuse, 
the answer is delayed until a more convenient season. The inclina- 
tion may not return again until twelve or twenty-four hours have 
elapsed. One oversight begets another, and in a short time irregu- 



CONSTIPATION. 511 

larity is the rule and constipation is more or less firmly seated. The 
plan of building privies two or more rods from the house, thereby 
exposing people to the inclemency of the weather, is rapidly and 
rightly growing into disuse. The water-closets and earth closets in 
residences and stores are not only advantageous but accord with com- 
fort and health. Shop and factory hands, particularly females, are 
terrible sufferers from constipation. Superintendents should see 
that closets are supplied in sufficient number and in convenient 
places. Already in cities retail stores are meeting the public wants 
in this particular. 

The treatment is simple or complex, according to the severity of the 
disease. Regularity in the movements of the bowels is the founda- 
tion of health, and the sooner the people understand this the better. 
A regular hour each day should be set apart for this particular pur- 
pose, say immediately after breakfast is finished, and nothing should 
be allowed to prevent the performance of such an important duty. 
One of the best aids in this matter and the best physic by far is cold 
water. When the teeth are cleaned upon rising and the throat gar- 
gled with water, then a half glass of pure cold water may be swallow- 
ed. This has the effect of rinsing the stomach and upper intestines, 
dissolving the excrement and impelling it forward. By the time 
breakfast is finished it has readied the exit. If further assistance is 
necessary a draught of water may be taken upon retiring, and in ad- 
dition one meal during the day may be composed largely of fruit and 
grain. We are of the opinion that graham flour is irritating and hence 
suggest the employment of cracke 1 wheat, oat meal, barley or rice. 
A fruit that can be had in most latitudes and countries is the apple. 
Raw, it disagrees with some dyspeptics, but stewed is relished by 
all. Sedentary habits have their unfavorable influences, hence some 
exercise, if only walking, is necessary. 

When constipation has bee >me more severe, injections of tepid 
water may be necessary. We prefer to invite the movement from 
below rather than force it from the bowels. Pills have their proper 
place and are valuable in commencing our efforts to overcome con- 



512 MEDICAL PRACTICE. 

stipation. "We prefer to all others the liver or anti-bilious pill con- 
sisting of: 

I?. — Aloes and Gamboge, each, . . one grain, 
Colocynth Compound, . . . one grain, 
Pulverized Castile Soap, . . . one-half grain. 

Mix 
The physician meets with cases of impaction of fifteen to thirty 
days, standing more frequently than the unprofessional would believe. 
The feces a>e so hard and the bowels so weakened that it is almost 
impossible to effect dislodgment by the use of injections and cathar- 
tics. A favorite which in almost every instance removes hardened 
feces, is calcined magnesia. It seems to create a copious flow of 
water and dissolving the excrement, gently urges it on, until evacua- 
ted. AVe use it in this w ay. 

1^. — Calcine! magnesia, . . . ateaspoonul, 

Milk or Syrup, .... two ounces. Mix. 

Take at one dose, and repeat every two hours. One hour after 
each dose take a half-tumblerful of hot lemonade. 

Obstructions in the Bowels. 

These may be due to misplacement of a knot of a bowel as in her- 
nia or rupture, to malposition of some internal organ as the womb, to a 
tumor growing in the bowels, or to indigestible substances which 
have been swallowed, such as fruit-stones, false-teeth and lhe like. 

Hernial obstruction is detected by the enlargement or swelling 
in the groin, by the pain, by the motion of the intestines, feeling un- 
der the hand like the parsing of a wave, by the v. miting which con- 
tinues with little iutermission, and which, at a later stage, is mixed 
with fecal matter. The bowels become swollen, painful, the patr nt 
pale, coll and exhausted. Hiccough is a symptom of dissolution. 
Every effort should be made 10 return the hernia into the abdomen. 
Sometimes position will effect it. A stout person may clasp a per- 
son about the knees and hold them with head downward and just 
touching the floor. Another plan is to have the person lay upon the 



OBSTRUCTED BOWELS. 513 

back with the hips well elevated and the leg upon the obstructed 
side well flexed upon the abdomen. The groin may then be gently 
but firmly rubbed from below upward by the hands of the attendant. 
The hands should follow each other, beginning with pressure at the 
lower part with one hand, just as the other is leaving the upper por- 
tion. This is called manipulation or taxis. The patient is aware of 
the fact if the intestine returns to its proper place. Another plan, 
simple but very important, and to be adopted in case other means 
fail, is upon the principle of cupping. A fruit-dish or large bowl is 
heated by burning in it a piece of paper or a teaspoonf ul of alcohol. 
While hot, this is to be placed upon the abdomen and allowed to 
cool; the cooling may be hastened by wiping with a piece of cloth 
wet in alcohol. Some slight pressure should be exerted upon the 
vessel so as to prevent the ingress of air. When cool it has taken up 
considerable of the flesh and will hold securely. Lifting this up- 
ward evenly, and with care so as to prevent loosening, much force 
may be used. The result is that there is a drawing inward toward 
the cup, and if fortunate in the experiment this will draw the strangu- 
lated gut back to its place. If possible, the timely aid of a surgeon 
should be secured. 

Constipation, due to falling backward of the womb, is neither so 
dangerous nor accompanied with such violent symptoms as the above. 
With the womb restored to its natural position and kept there by 
artificial support or other means, the relief is immediate, and with no 
other cause in operation, the bowels resume their natural functions. 

Obstruction does not always immediately follow the swallowing 
of indigestible substances. When it does it is more readily and success- 
fully treated because the cause is known. In such a case a hearty 
meal may be taken of mush and milk, to be immediately followed by 
the administration of prompt and powerful cathartics, such as 

1$. — Podophyllin, four grains, 

Pulverized Opium, two grains, 

Cream of Tartar, . . . . . one ounce. 

Mix. 
22* 



514 MEDICAL PRACTICE. 

Mix thoroughly and make four powders and take one every hour. 
Or 

1$ — Croton Oil, two drops, 

Olive Oil, . .... thirty drops. 

Mix and take ten drops every twenty minutes. 

Intussusception is a common kind of intestinal obstruction. It 
results from injuries, and in children sometimes from tossing them 
in the air and catching them upon the hands, the fingers pushing 
upon the abdomen. The bowel slips upon itself or into itself. The 
condition may be likened to the folds of a glove upon the finger 
which has been on, partly pulled off by folding over itself and 
again drawn back, making three thicknesses (two folds). Inflamma- 
tion follows quickly, hemorrhage takes place, and in a short time 
decay. If the swelling is sufficient to close the tube, it is still cura- 
ble, but if the intestin * divid< s by sloughing the case is almost hope- 
less. The symptoms are pain at the poin;s of folding and a bunch 
resembling a turner to the touch, followed by vomiting, constipation 
and s 'Ci by bloody diarrhoea. 

The treatment is an effort to unfold the bowel by one or two 
methods. First, by the use of a cathartic such as calcined magnesia, 
which will, by irducing peristaltic acti< n, relieve; or secondly, by 
copious injections of w»ter into the rectum, which has a mechanical 
effect only. It is expert d by excessive extension of one part of the 
intestines lo stretch another and perhaps the part folded. In case 
of such a fortunate event, manipulation will discover that the tumor 
has disappeared. 

DISEASES OF THE RECTUM. 

The rectum is the terminal portion of the bowel and has upon i's 
lower border a circular opening called the anus. This opening is 
controlled by a strong sphincter muscle. The diseases to which this 
part of the body is most subject are Fistula o • pipes through the flesh; 
1 issure, or ulcerated cracks; Piles or painful tumors, sometimes ble^d- 



FISTULA. 515 

ing; Prolapsus or falling of the rectum beyond and outside of the 
sphincter muscle and Stricture or closure of the pipe. 

Anal Fistula.— Fistula in Ano. 

These begin in abscess ulcer or injury as by penetration with a fish 
bone. The abscess may find its way to the bowel and open inward, 
may burrow to the skin about the anus and open outward or spread 




BECTUM SPECULUM. 

in both directions. The latter is called 
complete fistula, the others incomplete. 
In all cases a pipe is formed with hard- 
ened sides which does not heal. There is 
a slight prominence at its exit which marks 
its location. Matter is discharged from it. In complete fistula gas 
and fluid portions < f the excrement p:ss through and soil the clothes. 
A fistulous tube may have several branches and external openings 
with fortunately but one into the rectum. The pain and soreness of 
incomplete fistula is often ascribed by the patient to piles. Careful 
examination will decide the matter. When tue history discloses the 
previous appearance of a swelling (the abscess), painful while it re- 
mained but which rather abruptly departed, suspicion strongly 
points to fistula. 

TREATMENT. 

Two plans are adopted. One by the knife in which the pipe is 
laid open by an incision carried through the flesh lying between the 
fistula, bowel and external surface. The other by a ligature passed 
through the pipe and bowel and tied. This is daily tightened until 
it cuts its way through. The former is more prompt, the latter more 



516 MEDICAL PRACTICE. 

tedious and painful but less dangerous. Caustics are used to destroy the 
callosity of the fistula before the ligature is inserted. Cure, to be com- 
plete, must include all the tubes. In persons with pulmonary com- 
print the question of sufficient strength to bear the shock must be 
decided before operaiion. In all cases the blood should be purified 
and the system brought to its best condition before local treatment is 
undertaken. 

Fissure. — Fissura Ani. 

This, as its name implies, is a cleft or crack in the folds of the mu- 
cous membrane of the anus of an ulcerous nature. It is attended 
with itching and pain. The pain is not increased during stool; but 
occurs sometime after a passage, a half hour or so. 

TREATMENT. 

The fissure should be kept clean and the bowels soluble. Intro- 
duce every night into the bowel a piece of lint wet in a solution of one 
part of tannin and ten parts of glycerine. The antiseptic ointment 
answers every purpose and heals the parts promptly. At uight the 

Jself-ret;iining pile-pessary may be introduced well 
cuver^d with the ointment. 



Falling of the Rectum.— Prolapsus Ani, 
Proctocele. 



From relaxation of the muscular walls of the 
rectum or fibres of the sphincter muscle, or both, 
the mucous coat becomes inverted and escapes 
outside the body. The extent to which the 
bowel may fa 1 varies, some cases being reported 
in which six inches have protrude 1. Heavy lift- 
ing, jumping, straining at stool, excessive and ex- 
hausting labor during hot weather, sedentary hab'ts and constipation 
are among the usual causes. There is a feeling of fulness and weight 
about the anus, a continual effort is ma le to constrict the muscle, 



PALLING OF THE RECTUM. 517 

the step is measured in walking, elevations are avoided and the 
thighs are closely approached. The hand is carried frequently and 
almost involuntarily to the fundament to afford support and replace 
the prolapse. 

TREATMENT. 

For cases of long standing the pile compressor is recommended. 
This is a truss made for the purpose of affording artificial support and 
is comfortable and effective. Means hereafter mentioned may then 
he employed to restore tone to the relaxed muscles. If of recent 
date rest a few days in bed with the hips and feet elevated and the 
shoulders low. Use fluids for food, such as milk, soups, and fruit. 
Abstain from wheat bread, coffee and tobacco. The bowel * may 
move several times a day under this treatment, but the dejet tions are 
soluble and unirrita in^. After each movement bathe the inflamed 
parts with witch hazel tincture, a tablespoonful to a pint of cool 
water and return the bowel. Knead the abdomen gently when lay- 
ing down. Take every two hours a teaspoonful of 

1$. — Tincture of Nux Vomica, . . thirty drops, 
Tincture of Witch Hazel, . . one dram. 

Water, sweetened, . . . four ounces. 

Mix. 

Upon retiring pass i:ito the reclum a suppository made of antisep- 
tic ointment and tannin, a teaspoonful of each. Divide in four, Use 
one. Upon first attempting to walk or work, use the self-retaining 
pile-pessary. Even if it is not used, it may I e well to have it in the 
pocket in the case of emergency. This treatment succeeded on two 
occasions in the author's personal experience. 

Stricture of the Rectum. 

The diminished or contra' ted condition 'of this part of the bowel 
may be spasmodic or permanent. These are distinguished from each 
other by passing up the rectum a bougie about the size of the finger. 
If it passes at one time and not at another, it is spasmodic. Perma- 



518 MEDICAL PRACTICE. 

nent stricture may be benign or malignant. In the latter it may be 
cancerous, particularly if high up or just within reach. In stricture, 
the feces will be expelled with difficulty and are ribbon-like, or like 
tape-worm, or like small bullets. The cure is by forced dilitation, 
which is accomplished by properly constructed instruments. 

Hemorrhoids. — Piles. 

Piles are painful tumors situatt d within or near the anus, resulting 
from excessive dilatation of the veins distributed to the lower bowel. 
In most cases there is impairment of health. They are called 
blind, bleeding, external or internal, according to their character and 
position. "Whenever people neglect to attend to the regular evecua- 
tion of the bowels, disregard the necessity of physical exercise, in- 
dulge habitually in rich food and stimulating beverages and allow 
the pores of the skin to become clogged with impurities, piles will 
be the result. The habit of sitting continuously for a length of 
time is popularly considered the principal cause, but a little investi- 
gation will show that printers, find others who stand at their work, 
are r.s much affected as the sedentary class. When hemorrhoids are 
commencing there is some pain and uneasiness about the rectum, 
with itching about the anus, and darting pains in the loins and pelvis; 
headache, vertigo, and flushes of heat sometimes; languor, disincli- 
nation to exert mind or body, and irritable and peevish temper. 
Restlessness, loss of appetite, coated tongue, nausea, constipation, 
may be present. Small painful turn rs will then be found at the 
margin of the anus or just within the rectum. Although slow in 
forming, they appear to the patient suddenly while straining 
at stool, when the feces are hardened. Soon they increase in size, 
become tender and painful, slip out of the bowel and bleed. The 
tumors can be replaced by the fingers at first, but the time comes 
when they remain protruded. Constipation becomes habitual and 
the abuse of cathartic medicines, or their injudicious selection, in- 
creases the difficulty. The countenance becomes sallow, the skin 
dry and harsh, the spirits depressed, with frequent headache and 



PILES. 519 

back ache. The disease sometimes lasts for years without giving 
rise to any external evidence of deranged health. On the other hand 
the constant irritation may so annoy,and the bleedin'g so deplete, as to 
tell upon the general health. Piles may discharge at the menstrual 
period. 

The indications are to disgorge the bowels, keep the movements 
regular and soluble, free the liver circulation, and with it the circu- 
lation in the distended veins, and relieve local inflammation and 
hemorrhage. . 

TREATMENT. 

It is almost unnecessary to say that mechanical obstructions must 
first be removed, such as abdominal tumors, tight clothing about the 
waL-t, chronic liver disease, pin-worms in the young; diseases of the 
womb, as congestion smd retroflexion, must first be cured. In the 
latter months of pregnancy, relief only can be expected. The first 
indication is met by the use of an efficient but unirritating anti-bilious 
physic, as elsewhere noticed, or teaspoonful doses of calcined mag- 
nesia in sweetened milk, twice daily, for two or three days, or 
$. — Aloes, (socotrine), . . . twelve grains, 

Extract of Nux Vomica, . , six grains, 
Extract of Hyosciamus, . . eig! teen grains. 

Mix. 

Make twelve pills and take one pill two or three times daily. The 
bowels may be kept regular by the use of grain and fruit diet, absti- 
nence from use of tobacco, and general directions noticed ^hen 
treating of constipation. For the hemorrhage, a solution of tannin 
one ounce in half a pint of water, may be used as a wash or as injec- 
tions. If the piles are external, apply the tannin in powder, or the 
powder of persulphate of iron. If internal, one dram of the per- 
sulphate can be mixed with one ounce of antiseptic ointment and 
passed into the bowel by a suppository syringe. This syringe is 
made of hard rubber and has a hole about one quarter of an inch in 
diameter its whole length. This is filled with the ointment and then 



530 



MEDICAL PRACTICE. 




8TTPP08ITORT 8TBINGS. 

introduced into the bowel. The piston is now pushe 1 throu :h, which 
dislodges the suppository when the instrument is withdrawn. It is 
simple but convenient and valuable. Care should be used to smear 
t e outside with the ointment, which facilitates its use, and to cleanse 
it thoroughly with soap and warm water after use. If the hemor- 
rhage is excessive, the patient should seek the recumbent position, 
and the persulphate of iron mm d with water, should be used as 
an injection. The inflammation may be overcome by r st, plain 
food and frequent bathing the parts with cool water, or, much bet- 
ter, waler io each pint of which is added a t:aspoonful of tincture 
of witch hazel. The application of an iseptic ointment alone to the 
anus eacli light upon retiring, has a remarkably soothing, healing 
and beneficial effect. 






LOCAL DISEASES. 



ORDER IX. DISEASES OF THE KIDNEYS 
AND BLADDER. 



Inflammation of the Kidneys — Renal Congestion. — Nephritis. 



This malady is not so frequently met as a disease of itself as an 
accompaniment to other affections and constitutional disturbances. 
Renal congestion attends most malarial and eruptive fevers, some 
heart and lung diseases, and sometimes inflammations, colds, rheuma- 
tism, and pregnancy; inflammation attends injuries, calculus, and 
the use of alcoholic beverages. Congestion affects both, and inflam- 
mation generally but one kidney, otherwise their symptoms are the 
same, except in intensity. There is dull or sharp pain in the small of 
the back, tenderness upon pressure, feverish pulse and skin, numb- 
ness of thighs, testicle drawn up, and urine passes with difficulty, or 
may be entirely suppressed ; that passed is scanty and dark-colored. 
The urine may be bloody and some limes contains purulent matter, 
{pyelitis.) 

It is distinguished from lumbago by causing little if any increase in 
the pain upon bending the body, so as to call into play the muscles 
of the back; from colic by having fever and urinary troubles, and by 
the pain being in the back; and from Bright's disease by the absence 
of albumen, by retraction of the testicle and by greater ft vcr. 
treatment. 

It is evident that diuretics or those remedies which stimulate the 
kidneys are out of place here; in fact turpentine, cantharides, etc., 



Acetate of Potash, . 
Tincture of Colchicum seeds, 
Es^euce of Wintergreen, 
Water, 



522 MEDICAL PRACTICE. 

oftener produce nephritis than relieve it. The treatment of renal 
congestion occurring so frequently in fevers admits of them in a 
mild form ; we prescribe 

1}. — Spirits of Nitre, .... three drams, 

. two drams, 
. four drams, 
. one dram, 
. three ounces. 

Mix. 

Dose, a teaspoonful every two, three or four hours. In pregnancy 
the congestion resul's from pressure, not so much upon the organs 
as upon the blood vessels supplying them. The relief comes with 
delivery. 

Unless something counter-indicates, we prefer by revulsive mea- 
sure to equalize the circulation by calling upon the skin and bowels 
to carry away the fluids and impurities; substitute the functions of 
the kidneys and rest these organs. Foremost among such means 
stands the spirit vapor bath. This may be assisted by the use of cal- 
cined magnesia in teaspoonful doses in milk or water every three or 
four hours, it" deemed necessary. When the strength will admit and 
a change of irritation to the bowels is desirable 

3$. — Podophyllin, , two grains, 

Cream of Tartar, .... two drams. 

Mix thoroughly and make four powders. 

Give one in syrup and repeat every three hours while necessary. 

Bright's Disease. — Albuminuria. 

Bright's disease is becoming common in this country, and in most 
cases is directly traceable to the excessive use of alcoholic beverages 
as a cause. It may however be produced by prolonged exposure to 
cold and moisture. It often accompanies pregnancy, and if 
excessive at the time of delivery, is likely to culminate in con- 
vulsions. It follows or accompanies other diseases, but more 



BRIGHT'S DISEASE. 523 

especially scarlet fever and specific diseases of the urinary tract. 
Its beginning has much the appearance of chills and fever, with 
the nausea, sometimes vomiting, pain in the head and back, 
and difficulty in breathing. The water passed is scanty, dark- 
colored and loaded with albumen, which gives the name to the dis- 
ease. Following this a general dropsy of the surface is noticed, par- 
ticularly of the face and legs, and sometimes in the chest or abdo- 
men. 

It is distinguished from other diseases affecting the lower part of 
the back principally by the examination of the urine. We cannot 
here describe the distinctive tests which are made by the microscope, 
but any person may discover the presence of albumen. A small 
portion of the water is placed in a test tube or other glass vessel, and 
the fluid heated to the boiling point. A few drops of nitric acid is 
then mixed with the fluid, and the albumen becomes white, resem- 
bling to some extent the white of an eg^ when subjected to heat. 

The kidneys are sensitive to the touch. The pressure upon the 
small of the back on either side of the spine causes pain. 

The indications are to remove the local congestion and to eject 
fluid from the body through other channels, thus relieving these 
organs. 

TREATMENT. 

A paste of ground mustard mixed in cold water may be applied to 
the small of the back, over the kidneys, but should be removed be- 
fore blistering, and a cloth wet in oil put in its place until the red- 
ness disappears. The process can then be repeated. If the pain is 
severe a hot compress may be applied or a liniment composed of 

1$. — Tincture of Aconite root, 
Tincture of Arnica, 
Laudanum, . . . equal parts of each. 

■ 
Mix and apply by a cloth. All remedies tending to increase the 
flow of urine should be carefully avoided. 



524 MEDICAL PRACTICE. 

The spirit or the Turkish bath are of great importance. Fluid 
may be carried away by the bowels by the use of 

I£, — Podophyllin, . . . two grains, 
Cream of Tartar, one ounce. 

Mix and divide into four powders. Take one in syrup or mo- 
lasses. Another plan, having the advantage of being more pleasant, 
is to administer teaspoonful doses of calcined magnesia every two 
hours, taking an hour after each, a glass of lemonade. "When the 
bowels have moved freely the cathartics should be discontinued and 
a pill or powiler of tannin, one grain, taken every two hours, with 
or without the citrate of iron and strychnia pills, The diet should 
consist principally or exclusively of milk. "When an exclusively 
meat diet is used, albumen, in quantities, sometimes great, some- 
times small, appears in the urine. Wheat gluten is valuable, but is 
unpleasant to many if taken alone, from its tenacious character and 
raw taste. Considering the nature of the difficulty, such objections 
should be overruled, but habit and appetite are almost uncontrol- 
able. 

"When the disease becomes seated the indications of treatment 
remain about the same, but the difficulty does not yield so readily 
and in fact will sometimes baffle the most skillful. 

As a rule every inflammation of the kidneys, if of recent appear- 
ance, may be successfully treated by this plan. 

Hematuria or bloody urine is removed by the same means, with, 
however, a single exception. Instead of lemonade, frequent drink of 
a tea made of dried peach leaves should be taken. Some of the 
worst cases yield to this decoction within forty-eiglit hours. 

Uraemia is poisoning of the blood by urea, a common constituent 
of the urine, and which, from the inactivity or congestion of the kid- 
neys, is retained in the system. It may be suspected when the pa- 
tient has not passed water for a considerable length of time; from 
one to three days. Before this opinion is formed, however, a careful 
examination should be made to see that the bladder is not great 1 



DIABETES. 525 

distended. If it is, a solid ball will be felt immediately above the 
pubic bone. But when the bladder is empty retention may be sus- 
pected. When unrelieved, we have, following closely upon each 
other, the symptoms of severe headache, bowel disturbances, twitch- 
ing and coma or gradual increasing insensibility. Uraemia is but a 
symptom of a disease and that disease usually is congestion of the 
kidneys; so that the course of treatment above recommended is well 
suited to retention. 

Sugar m the Urine.— Diabetes Mellitus. 

Sugar in the urine can only be detected by chemical test, and when 
found upon a single occasion has little significance. When the 
amount of the urine passed is excessive and appears to increase, not 
so much from day to day as from week to week, chemical examina- 
tion should be made daily, and if sugar is present a correct diagnosis 
can be made. Rarely does the disease come to the physician's at- 
tention in its earlier stages. This is due to the fact that the accumu- 
lation is great and evacuations, take place so frequently and with 
such freedom that the afflicted parties incline to the belief that their 
health is improved rather than retrograding. Increasing thirst may 
be first noticed, or perhaps, loss of flesh, slight but gradually aug- 
menting, accompanied with dry and rough skin, parched mouth, 
tenacious saliva, catarrh of the lung* and bowels, finally terminating 
in dropsy of the limbs, hectic fever, and the other conditions and 
symptoms properly belonging to consumption. 

It is distinguished from other urinary difficulties by the excessive 
urination and the presence of sugar. 

The indications are two-fold: to diminish to the least possible 
amount the starch or sugar taken with the food, and to administer 
such judicious tonics as will preve t the liability always present in 
this disease, to take on local inflammatory processes. 

TREATMENT. 

This is somewhat clouded in doubt, on account of the want of an 



526 MEDICAL PRACTICE. 

exact knowledge of the disease All physicians are agreed that starchy 
and sugary food should be discontinued. This excludes from the 
dietary potatoes, bread, sweetmeats and fruit3. The diabetic flour 
and crackers have the starchy principal extracted. The bitter tonics 
and the citrate of iron and strychnia have been recommended, and 
in some instances, have cured. The cod-liver oil and hypophosphaies 
recommended in consumption, are of advantage in affording nour- 
ishment and retaining strength. We believe it to be a disease of the 
blood and nervous system, and our treatment, based upon this theory, 
gives far better results than any other. The Turkish bath or spirit 
vapor bath, is a valuable adjunct. Exclusive meat diet with green 
vegetables and a diet of skim milk, are strongly advocated. Better 
consult a good physician early. Diahetis insipidus, in which there is 
an excessive flow of urine but no sugar, is more susceptible to cura- 
tive measures. 

Irritation op the Bladder, Vesical Irritation. 

Males are frequently troubled with this complaint and usually 
imagine that it arises from, or actually is, the specific disease. There 
is a slight mucous discharge. The desire to pass water is frequent 
and urgent, and there is pain when the urine starts and stops. The 
mouth of the urethra is not red and swollen as in gonorrhoea. 
The patient complains of a dull ache and a sensation of heaviness 
between the anus and scrotum. 

TREATMENT. 

In many cases it will vary little from that about to be recommend< d 
for inflammation of the bladder. The bladder, its neck, and the 
prostate gland are so close to the rectum of the male that treatment 
may be given by this channel. A two or three grain pill of opium 
lodged in the rectum at night and in the morning will be all that is 
necessary. 



DISEASES OF THE BLADDER. 527 

Inflammation of the Bladder. — Cystitis. 

Inflammation of the bladder is not always confined to the organ in 
question, as its name would imply. Its inception is local, but from 
the contiguity of tissue it may spread upward toward the kidneys, 
downward along the urethra; may involve the peritoneum, the pros- 
tate gland of the male, or the vagina and uterus of the female. This 
inflammation may arise from external or internal causes. Among 
the former the principal is from injuries. Internal irritation may 
arise from the presence of stone and, which is most general, from 
irritating urine, particularly that confined by stricture. Certain 
substances, as turpentine taken with the food, may inflame the 
bladder. 

The symptoms are local and always attended with more or less 
pain. This pain is seated low down in the abdomen and to the front, 
immediately above the pubic bone. There is pain and more or less 
scalding upon passing water. The desire to micturate is frequent, 
attended with little flow and preceded and followed by violent con- 
tractions of the organ, (tenesmus.) The urine is scanty, high-col- 
ored, and deposits a cloudy or milky substance, sometimes tinged 
with blood. 

It is distinguished from inflammation of the kidney, principally, by 
the locality of the pain ; that of the kidneys being in the small of the 
back ; from inflammation of the womb by the greater bloating and 
by the higher fever, together with menstrual irregularities. Occa- 
sionally the falling forward of the womb causes direct pressure upon 
the bladder, inflaming it. 

Chronic Cystitis is more commonly known by the term of Catarrh 
of the bladder. It is of long standing, developes more tardily, and is 
recognized by the patient by the frequent desire to urinate, the small 
amount escaping and the continual presence of a thickly viscid de- 
posit in the water. The pain is not so great as in acute attacks, but 
although less severe in character, is almost constantly present. 

The indications are to remove the physical causes of irritation, if 
any exist; to change the character of the urine and preserve its nor 



523 MEDICAL PRACTICE. 

mal standard : and to relieve the inflammation and limit its spread- 
ing;. 

TREATMENT. 

If calculus or stone has already formed, surgical means must be 
sought for its removal. The fame may be said of the antiflected 
womb. If gravel in fine particles is passing, the adoption of a prop- 
er diet and the employment of the means about to be mentioned 
would be sufficient. 

A kind combination which not only affects the character of the 
urine, but calls into activity the bowels, and assists in removing mor- 
bid matter from the. bladder, is the following: 

Citric acid four drams. 

Pulverize and divide into eight parts. Put in blue papers. Also 
Bicarbonate of Potash, . . . one ounce. 

Divide into eights parts. Put in white papers. 

The above are administered the same as Sedletz powders. In a 
half tumbler of water is dissolved a powder in the blue paper. And 
in another half tumbler of water is dissolved a powder in the white 
paper. To one of the tumblers add a teaspoonful of sugar. When 
each are well dissolved pour together and drink rapidly. The effer- 
vescence is but momentary, and it is during its action that the drink 
should be taken. This should be repeated every two hours. 

The inflammation may be treated in several ways. A hot com- 
press may be laid upon the lower abdomen, with advantage; or a 
mustard paste made of pulverized mustard and ginger, may be ap- 
plied and continued until the surface is well reddened, then remove 
to make way for the compress. An injection should bo thrown into 
the bladder. The difficulty in the way of adopting this treatment 
lies mainly in the introduction cf the catheter. 

While the operation is a simple one in the hands of a physician, it 
is not only complicated and difficult, but sometimes likely to be at- 
tended with injury, when attempted by a novice. What is wanted 
in case the draughts and revul>ives above indie. i ted are not sufficient- 
ly successful, are the cleansing and soothing influence of glycerine 
and the healing property of golden seal. My remedy is 



INFLAMED BLADDER 




Glycerine, one-half ounce, 

Fluid Ext. Golden Seal, . one dram. 

Mix and add to a pint of warm water a table- 
spoonful. Fill the bladder with this mixture every 
three or four hours. 

Thee is a method of injecting fluids into the 
bladder without the use of the catheter. If a- 
streim of water or other fluid is introduced into the 
urethra, it will, if entering under sufficient pressure, 
gradually dil ite the sphincter vesicce, and it may 
be caused t > enter the bladder w r hen through in- 
flammation or otherwise the urethra is so sensitive 
as to prevent the passage of a metal or gum 
catheter. 

In Dr. Berthole's method the patient sits on the 
floor with his back against the wall, thighs and 
knees turned out, and the toes turned in. • A vessel 
is placed conveniently to catch any water which may 
escape. An irrigator with a long tube, with a 
stop-cock somewhere in its course, is placed upon 
a bench near by. The tube of the irrigator is well 
oiled and is inserted into the urethra; and the 
patient keeping this in place with the left hand 
can easily regulate the flow of the fluid with his 
right hand upon the stop-cock. When the latter 
is opened, the water usually penetrates into the bladder without the 
patient's bcin^ conscious of its entrance. So soon as he feels the de- 
sire to urinate, the stop-cock is to be turned off, as the bladder is 
then full. The patient can now empty the bladder at once or can 
retain the fluid some little time. The water should be warmed to 
the temperature of the body, and the best time for employing the in- 
jection is just before going to bed. A single injection, in cystitis, 
will thin the stagnant urine and deprive it of its irritating quality. 



I 



530 MEDICAL PRACTICE. 

The sulphite of soda is a good remedy in five to ten grain doses 
three times a day. 

Retention of Urine. — Dysvria, Stranguria, Ischuria. 

The medical terms express the different degrees of retention: 
dysuria the urine passes from ihe bladder, but is accompanied with 
1 ain ; in stranguria, the neck of the bladder is inflamed and the urine 
only escapcsin drops; and in ischuria, no matter how full and distended 
the bladder, there is complete inability to evacuate it through the 
natural channel. In all cases, retention implies that there is fluid in 
the bladder and that it is discharged with difficulty, or if complete, 
expulsion is impossible. This is a common complaint, occurs in all 
ages, and has many and various causes. It will 1 e necessary to no- 
tice these in order that a rational treatment may be used. It arises 
from obstructions such as stone in the bladder, enlarged prostate 
gland (prostatitis is a common affection of the aged), stricture of the 
unth: a and anti-flexion of the womb; from irritation by drugs, as 
car.tharides or Spanish fly, turpentine, and in one instance we found 
it result from an extensive blister upon the surface made by croton 
oil, also intestinal worms and dysentery. It is frequent in some diseases 
as fevers, particularly scarlet fever, gonorrhoea and syphilis: attends 
hysteria, some affections of the brain, and paralysis general and lo- 
cal. The water may be held until by over-distention contractility 
is lost and 1 1 e retention is complete. In most instances what is at 
first incomplete may become complete. 

TREATMENT. 
Generally there is no great hurry, so that mild means- may be em- 
ployed before recourse is had to instrumental relief. In hysteria it is 
only necessary to plunge the hands into cold water. In fevers, ap- 
ply a hot compress sprinkled with spirits of camphor over the region 
of the bladder. Another plan is slipping a piece of ice into the rec- 
tum or Living a small injection of ice water. Sitting in a tub of 
warm water is sometimes effective. Some persons in health are un- 
able to pass water in the presence of a second party : this timidity 



RETENTION OF URINE. 



531 




may be aggravated during sickness, and attend- 
ants should recognize the fact and always leave 
the room when a patient attempts to micturate. 
The sound of running water influences some fav* >r- 
ably. For children with worms, give santonine 
(see worms). We r< member a patient, a lad of 
ten years, who was dosed a whole year fcr 
diseases of the kidneys and bladder, who was 
cured in two clays by this remedy. In very 
small doses it is good for retention in infants in 
every case. Mix five grains with a teaspoonful 
of sugar. Give ten grains evefy hour. In adults, 
when retention results from paralysis, obstruc- 
tions or distention, it will be best to use the 
catheter. These are now manufactured of soft 
rubber, or jointed so that any one 
may pass them. Old men have 
frequently to use these instru- 
ments and should supply them- 
selves with these improved paterns 
and no longer run the great risk 
of doing themselves great injury. 
When other means fail, the sur- 
geon punctures the bladder over 
the pubic bone. 

JOINTED CATHETER. 

Incontinence of Urine, Dribbling. — Enuresis. 

Inability to withhold the urine would appear to be 
the opposite of the condition just described, and so 
it is in many cases, but some- 
times in fevers we have dribbling 
with retention. The bladder is so soft rubber catheter. 

full that that which escapes may be called the overflow. Hence the 




533 MEDICAL PRACTICE. 

necessity of daily examination, for the touch wid easily recognize the 
hanl round ball above the pubic bone if the bladder be fu'.l. Incon- 
tinence attends other diseases such as stone in ihe bladder, worms, 
constipiitiou, masturbation, womb diseases, acid urine, binding fore- 
skin, etc. The urine may escape only at right, (bed-wetting) or by 
day and night. It increases by laying upon the back, m:iy come sud- 
denly by fright, or in those of r< laxed habit, by coughing Bed-wet- 
ting in children, if habitual, is quite probably involuntary, and the 
child is unconscious of the act. There arc several type"? of ihis 
malady. In one the dribbling continues day and night, is influenced 
by coughing, and the person is unable to throw a strong stream; the 
bladder occasionally retaining the urine for a short time, the demands 
for mictutrition requiring prompt attention. In another there is no 
trouble durinsr the day, the person can project the fluid with force, but 
the escape occurs at night. In the aged, the urine is voided con- 
tinually; there is change of structure and relief is doubtful. 

TREATMENT. 

It will be well to avoid liquids the latter part of the day and 
evacuate the bladder just before going to bed. The bed covering 
should bu light and the mattress hard. A cold bath every morning 
and attention to diet, will allay irritation and assist medication. 
In the first class described we would use 

1$. — Tincture of Nux Vomica, . . . one dram, 
Tincture of Witch Hazel, . . . one dram, 
Tincture of Wintergreen, . . . one dram, 

Simple Syrup, four ounces. 

Mix. 
Give a teaspoorful every four hours, and two at bed time. Or 
If.— Fluid Extract of Ergot, . . . one ounce, 

Simple Syrup, four ounces. 

Mix. 
A teaspoonful every four hours and nt bed time. 



INCONTINENCE OF URINE. 



533 



In the case of spasmodic incontinence, which occurs only at 
night, belladonna is a better remedy. This may be given in one-quarter 
grain pills of the solid extract (English), at bed time increasing grad- 
ually to three or four at a dose, if found nee ssary. 

A simpler but highly recommended remedy that may be used in 
both cases U the syrup of the iodide of iron and glycerine, i;i equal 
parts. Give a teasp >onful three times a day. Worms and other 
sources of irritation, should be removed. Some of these cases are 
intractable, but nine out of every ten can be cured. If : he above 
means do not cure after a fair trial, better submit the particulars to a 
skillful physician. The aged and incurable will consult comfort and 
cleanliness by wearing a rubber urinal. In male childran with bind- 




Fig. 2. Fig. 3. 

ing foreskin (phimosis), bed-wetting is sometimes cured by 
Fig. l.* circumcision. The operation has other beneficial results 
even if it should fail in this particular. Boys can prevent these un- 
pleasant signs of incontinence by sealing the foreskin or the urethral 

* Fig. I & 2 Urinals for males, day and night ; Fig. 3 for day use only ; Fig. 4 
Urinal for females. 



534 MEDICAL PRACTICE. 

orifice with collodion. Apply with a brush. It dries quickly, com- 
pletely closes the canal and prevents escape. When it is desirable to 
micturate remove the plug with the finger nail. 

Suppression of Urine. — Anuresis. 

This condition should not be confounded with retention, where 
the bladd" r is full, but the urine is not v ided. In suppression there 
is disease of the kidney and secretion i< impaired or discontinued. 
The bladder is empty and no urine passes. This is dangerous be- 
cause the blood becomes poisoned with the impurities and waste 
mat' rial which find exit through the uri :ary tract, and, as a conse- 
quence, the brain is overwhelmed. This occurs in diseases ul the 
kidneys and during or following fever?. 

TREATMENT. 

\Ye want to relieve the congested condition of the kidneys and 
carry away the suppressed fluids and impurities. A cathartic ■ of c 1- 
cined m gnesi i repeated every two or three hours until fre<- watery 
discharges, will d > this. But we have a better and more decisive 
means in the spirit vapor bath. The two may be combined if con- 
sidered necessary. This will be found to work better than using 
diuretics to stimulate the kidneys, which, in suppression, are of 
doubtful utility. 

Gravel in the Kidneys, Bladder or Urethra, see pages 491 
and 492 



DISEASES PECULIAR TO MEN. 535 



CLASS IV. GEJSTJSTETIC DISEASES. 



ORDER I— Of Man. 






Emissions. 

These are the occasional discharges of semen or seminal fluid in 
the male. They occur most frequently in the unmarried, but are not 
confined entirely to this class. Their frequency is much greater in 
the excitable, the debilitated and those of strong animal propensities 
than in the robust, the almost passionless and those whose habits or 
occupation calls for much physical exercise and labor. These dis- 
charges or "losses" as they are sometimes termed, because they take 
place independently of the will, almost invariably occur during the 
latter part of the night. Sensibility is restored during the ejacula- 
tory effort. Occasionally a dreamy, semi-conscious state of mind 
exists immediately preceding the act which offers a golden oppor- 
tunity to those of strong will, and so inclined, to arrest its progress. 
Arousing at once, changing position, and directing the mind to other 
matters will succeed in averting the catastrophe. That habit of 
mind which fosters a determination to be on the alert for the event, 
coupled with unstimulatmg or hygienic living, is here richly reward- 
ed, from one to six months passing with but a single emission, the time 
varying aniens paribus, with the temperament of the subject. This 
is'natiiral and should not unbalance the mind any more than it does 
the body. A feeling of lassitude may be noticeable the day follow- 
ing, but soon disappears. 



536 MEDICAL PRACTICE. 

CONTINENCE. 

So excellent an authority as Mr. Acton states that the occasional 
occurrence of nocturnal emissions or wet dreams is quite compatible 
with, health and is to be expected as a consequence of continence, whe- 
ther temporary or permanent. It is in that way that nature relieves 
herself. Continence, to be complete, must be both physical and 
moral; the thoughts must be pure as well as the body chaste. 

Says Prof. Newman: " Considering that in man the sexual appe- 
tite is not, as in wild animals, something which comes for a short 
season, and then imperatively demands gratification, but on the con- 
trary, is perennial, constant, and yet is not necessarily to be exer- 
cised at all, his nature cannot be harmonious and happy, unless it 
can right itself under smaller derangements of balance. But this is 
precisely what it does; and I cannot but think it of extreme import- 
ance not to allow a bugbear to be made out of that, which on the 
face of the matter, is God's provision that the unmarried man shall 
not be harmed by perfect chastity. That it is ever other than natu- 
ral, normal and beneficial, I never heard or dreamed until I was past 
the age of fifty. 

"On gathering up what I know, what! have read and what I 
believe on testimony, I distinctly assert — first, that this occurrence is 
strictly spontaneous, — that it comes upon youths who not only have 
never practiced, but have never heard of such a thing as secret vice ; 
that it comes on without having been induced by any voluntary act 
of the person and without any previous mental inflammation: next, 
that it occasionally comes upon married men, when circumstances 
put them for long periods in the position of the unmarried; more- 
over even when they become elderly it does not wholly forsake them 
under such circumstances. My belief is that it is a sign of vigor. 
At any rate I assert most positively that it is an utter mistake to 
suppose that it necessarily weakens or depresses or entails any disa- 
greeable after-results whatever." 

We have Sir Benjamin Brodie also as an authority for stating that 



EMISSIONS. _ 537 

the young man cannot expect to entirely free himself from emissions 
till marriage. 

Hence to a limited extent the operation of this function is in ac- 
cordance with health. The question of vital importance is, at what 
point is found the boundary of health, beyond which we may con- 
clude it to be a disease. All functions are deficient, normal or ex- 
cessive. The former and latter are considered disease of function. 
At this time we have only to do with the latter. 

"In man," remarks Kolliker, " ihe capability of producing semen, 
assuredly, always exists; although it d< es not appear to me to follow 
from this that semen is being continually formed, and that what is 
not emitted undergoes absorption: and consequently it seems justi- 
fiable to suppose ti at the seminal tubes secrete semen only when the 
secretion has been partially evacuate I externally — either in conse 
quence of sexual congress or of seminal emissions — and an excite- 
ment of the nervous system has caused an increased flow of blood to 
the testes." 

It is apparent that that which goes to make semen would if with- 
held in the system, make blood and muscle. It is also obvious that 
the amount of vital or nervous force which is required in the elabor- 
ation of the one, can be conserved and diverted to buld up the other. 
Hence when the amount evacuated is excessive, the amount of vi- 
tality and nutritive elements required to keep up the secretion is ex- 
cessive, and the body in other respects must suffer. This defines the 
limit and also establishes the rule that when the emissions produce 
weakness and debility they require treatment. Fortnightly or more- 
frequent emissions In most men are exhaustive and come under this 
head. 

Of those endeavoring to lead a continent life, the ill effects of too 
frequent losses are confined to the unwary, the imprudent and th^ 
careless. The unwary suffer because they do not fully appreciate 
the liability to danger and are as a consequence not on the watch* for 
lascivious dreams and their possible issue. The imprudent and care- 
less fail from all the causes which produce stimulation of the gener- 
23* 



538 MEDICAL PRACTICE. 

ative organs These are a full bladder upon retiring, constipation, 
late suppers, ihe use of tobacco and malt and alcoholic liquors, 
stimulating foods, the use of fruits late in the day, -which tends to 
distend the bladder during the night, lying upon the back, irritating 
secretions upon the member, the result of uncleanliness, and lewd 
thought and deportment. One cause, and a purely physical one, is 
a noteworthy exception to these; the excessive sensitiveness caused 
by elongated foreskin. This requires circumcision; — the others are 
removed easily and demand only thought and attention. This sub- 
ject we will f -rther consider under the title of 

SPERMATORRHOEA. 

Among medical authors there is a wide difference of opinion in 
regard to the correct description and definition of this disease. It is 
not to be wondered at, therefore, that the public at large should possess 
vague ideas and conflicting opinions respecting it. The young and 
middle aged man gathering with eager curiosity the ideal, romantic 
and vividly colored pictures in pamphlets and books emanating from 
quacks and their associates, finds not only every normal function of 
the reproduc'ive organs misinti rpreted, but their minutest irregu- 
larity greatly magnified (respecting their edects) and rest dts connected 
only with the most extreme cas.es \ ortray< d as natur.l and certain 
consequences. 

A simple definition is, the unnatural loss of scrrwn and its conse- 
quence. This is not a strictly correct one, but enough so to cover 
our purpose, and should be so interpr'ted in the lines that follow; 
any additional significance will be mentioned at the time the term is 
used. 

The earliest writers called it tabes dorsalis, a wasting of the back, 
because attended at first with a pain in the back or loins aud after- 
ward in the neck or hod. Possibly, from its effects upon the ner- 
vous system, t! e idea was cntertai. ed that the loss was in reality the 



SPERMATORRHOEA. 539 

brain substance itself. Camusdeclared.it to consist of microscopi- 
cal brains having the brain as their source. 

From the careful inspection of the histories of very many so afflict- 
ed, the majority become afflicted from one of two causes: in the 
married, sexual excesses, and in the married and unmarried, mas- 
turbation or self -pollution. In the former there is the lack of that 
good judgment which should govern all passions in order to reach 
the perfection of life, health and happiness. In the latter, a pardon- 
able ignorance for which the timid or procrastinating parent is much 
to blame. 

All must coincide with the views of Sir "W*. C. Ellis : — 

" However revolting to the feelings it may be to enter upon such 
a subject, it cannot be passed over in silence without a great violation 
of duty. Unhappily, it has not been hitherto exhibited in the awful 
light in which it deserves to be shown. The worst of it is that it is 
seldom suspected. There are many pale faces and languid and ner- 
vous feelings attributed to other causes, when all the mischief lies 
here. " 

At a convention of physicians in England, upon the discussion of 
the subject of spirituous liquors, it was agreed that much of the 
cause of intemperance should be laid at the doctors' door. Very 
many of the afflicted complain that the habits of inebriety began 
with a prescription. How much more ruinous is the advice that 
occasional masturbation is health-giving and necessary. The rea- 
sons given for it are silly and unscientific. That chafing the mem- 
ber will unload the seminal reservoirs and prevent emissions is 
certain. Will such advisers be responsible for the results ? Do 
they fully appreciate the fact that it takes the first glass to poison 
the appetite and lay the foundation of an irrefragable habit ? "It 
is easier," remarks Acton " to abstain altogether than to be occasion- 
ally incontinent and then continent for a period; and the youth is a 
dreamer who will open the flood-gates of an ocean and then attempt 
to prescribe at will a limit to the inundation." That this function is 
physiological, we admit, but that its use is necessary to preserve its 



540 MEDICAL PRACTICE. 

normal standard, we emphatically deny. Those having special ob- 
jects in view contend that restraint cannot be practiced without 
damage, both mental and physical Professor Burt G. Wilder ably 
refutes this sophisticnl proposition in the following language: 

" Who and how many are they that are now unable to restrain their 
animal passions ? Surely they are very few at this day, however 
numerous they may have been a century ago. For at ihat time rm n 
were large, full of blood and animal sp rits, comparatively co?.rse in 
organization, and able to do and to endure what is I eyond our 
powers. They worked harder, they drank deeper, ihey had less 
brain and more blood. Many even within our remembrance, were 
annually bled, and the change in respect to this and strong dosing is 
not merely a temporary revolution in medical practice, but is due 
quite as much to a real and recognized change in our physical 
organization. In some respects we may not be the better off, and 
thcro is certain 1 }' danger for ourselves and our descendants unlc-s 
some limit is set to the excessive nervous and mental activity whi h 
is so general and almost unavoidable. But in regard to sexual im- 
pulses, while the change has brought relief in one way, it has 
imposed responsibilities not before incurred. Formerly lust was 
born of the blood ; the very robustness of health was a temptation; 
the flesh was mighty and the spirit was weak; and the remedies 
were corporal and violent, like the disease. We may even charita- 
bly ndmit that there were some cases in which only blood-letting 
could, for a season, stay the raging fires of bodily passion. But it 
is not so now. Our foes are still of our own household, but they are 
Ihe eyes, the ears, the brain, the thoughts, the in agination, all those 
finer organs and subtler processes which our conditions of life stimu- 
late into highest activity, and tlicse we can c ntrol to an , rtent impos- 
sible hi the other caw. We may avert the eyes from th • indelicate, 
and close the ears to the obscene. We may will thai the brain shall 
invent labor-saving machines, and solve problems in science, in 
place of scheming how innocence shall be entrapped and lust be 



SPERMATORRHEA. 541 

gratified. Our imngination may be encouraged to aid our efforts 
toward the good and the pure, rather than the evil and the impure. 

"And while, no doubt, there are greater clangers from perversion of 
these faculties, and from the wide spread dissemination of evil books 
and pictures and filthy newspapers, yet, as already said, these are 
influences from which we can flee, and to which there is no excue 
for our yielding, not even the excuse of our forefathers, for it no longer 
exists with us." 

With a knowledge of this subject as already presented, it 
must be inculcated, and we wish to emphasize it, that treatment is 
moral and mental rather than medicinal; moral in elevatiug the 
afflicted above sensuality, mental in diverting the evil thoughts into 
other channels, and medicinal only in so far as is necessary to repair 
injuries already inflicted and diminish local congestion, while the 
other more important factors of relief are being strengthened. 

In tiie light of such truth, how can a doctor of medicine be so 
thoughtless or so ignorant as to advise cohabitation with the courte- 
san; or by what process of reasoning can he logica'ly conclude to 
counsel such a course, freighted as it is with inevitable moral defile- 
ment and with almost as certain syphilitic pestilence; a double-headed 
cancer that devours both body and soul. Thirty years ago the 
Quarterly Review published on this subject the following: " Its 
peculiarity and heinousne s consist in its divorcing from all feelings 
of love, that which was meant by nature, as the, last and intense-t 
expression of passionate love; in its putting asunder that which G. d 
has joined; in its reducing the deepest gratification of unreserved 
affection to a mere momentary and brutal indulgence; in its making 
that only < ne.of our appetites which is redeemed fron mere animaliiy 
by the hallowing influence of the better and tenderer feelings with 
which nature has connected it, as animal as the rest. It is a volun- 
tary exchange of the passionate love of a spiritual and intellectual 
being for the hunger and thirst of the beast. It is a profanation of 
that which the higher organization of man enables him to elevate 
and refine. It is the introduction of filth into the pure sanctuary of 



542 MEDICAL PRACTICE. 

the affection?. We have said that fornication reduces the most fer- 
vent expression of deep and devoted human love to a mere animal 
gratification. But it does more ihan this: It not only brings man 
down to a level with the brutes, but it has one feature which places 
him far, far below them. Sexual connection with them is a simple 
indulgence of a natural desire mutually felt; in the case of human 
prostitution, it is in many, probably in most instances, a brutal de- 
sire on the one sid^ only, and a reluctant and loathing submi-sion, 
purchased by monev, on the other. Among cattle the sexes meet by 
common instinct and a common will; it is reserved for the human 
animal to treat the female ; s a mere victim to his lu>t." 

This is resorted to from various motives. With many there is no 
opportunity for the natural gratification of their appetite; some are 
deterred from such gratification by the fear of discovery, regard for 
character, or a dread of disease; others there sire whose consciences 
revolt at the idea of lice:itions intercourse, who yet addict themselves 
to this practice with the idea that there is in it less of criminality. 
It is to be apprehended, however, that it - commencement can usually 
be traced to a period of life when no such causes have been in opera- 
tion. It is begun from imitation, and taught by example, long before 
the thoughts are likely to have been exercised with regard either to 
its dangers or its crminality. The preva'e- ce of this vice among 
boys seems to be connected with the great amount of illicit indul- 
gence among young men. It prepares the way, it excites the appe- 
tite, it debauches the imaginat o 1. There is little doubt that it is 
often, if not commonly, begun at a perio 1 of life when the natural 
appetite does not, and should not exist. It is solicited— ptematurely 
developed — it is almost created. On every account, then, this prac- 
tice in the young demands especial notice. It is the great corrupter 
of the morals of our youth, as well as a frequeut destroyer of their 
health and constitution. Could it be arrested, the task of preventing 
the more open form of licentiousness would be comparatively easy; 
for it creates and establishes, at a very early age, a strong physical 
tendency, an animal want of the most imperious nature, which, like 



SPERMATORRHEA. 543 

the longing of the intemperate man, it is almost beyond human power 
to overcome. The brute impulse beconcu s a hibit of nearly irresisti- 
ble force before the reason is instructed as to its injurious influence 
on the health, or the conscience awakened as to its true character as a 
sin. — (Ware.) 

Mental symptoms. Patients affected with spermatorrhoea gene- 
rally become languid, effeminate, pusillanimous. The power of mo- 
tion is very much weakened ; volition is readily excited, but does 
not last; there is a lack of firmness; the patient has the best inten- 
tions, but is unable to carry them out. In the more advanced stages 
of the disease the power of moiion is partially, if not < ntirely, de- 
stroyed. The patients become dimdent, irascible, sensitive, capri- 
cious. The least untoward event excites their anger, but grave in- 
sults do not seem to disturb them. Toward the female such patients 
are cold. They avoid the society of females and scarcely dare look 
them in the face. They prefer sol tude, are sad, low-spirited, mel- 
ancholy; i hey. like to indulge in glowing thoughts; th y are averse 
to any kind of work; they loathe life, and often thiuk of killing them- 
selves, nevertheless they are constantly desirous of recovering their 
health: they are ever thinking of their condition ; tiny observe the 
uiine and st« ol, watch their indige.-ton, and all the other functions; 
they show an indifference to every thing, neglect their busin< ss, and 
are tormented with the thought that they have lo>t their virile powers. 
Depression of spirits and hope, joy and sadness^ alternate in quick 
succes ion, accordingly as the involuntary losses of eem n occur 
more or less rapidly, or according as the patterns are impressed with 
the idea of either being better or worse. The memory is frequently 
impaired, and in persons endowed with higher intellectual powers 
the flight of idea is considerably embarrassed, the imagination loses 
its vivacity, and the acute and discriminating powers of the reasoning 
faculty are weakened. These symptoms, although they excite legiti- 
mate suspicions of the exi-tence of the disease are, however, not suf- 
ficient to remove all doubt in reference to it. A similar degree of 
uncertainty attaches to the 



544 MEDICAL PRACTICE. 

Physical Symptoms. The countenance is generally pale, eyes 
dull and leaden, with pimples upon the forehead or cheeks or both. 
These continue to spread, appearing in regular order upon the nose, 
the chin, the chest, back, arms, and evemually upon the buttocks, 
thighs and whole surface. The perspiration is profuse, and is par- 
ticularly noticeable in the palm of the hand, which has a cold, damp, 
clammy feeling. The crown of the head is hot, and the hair falls 
out. The throat is dry, sore sometimes, and voice husky, the first 
words spoken being indi-tinct and uttered with difficulty. The 
muscles are small and flabby and the body emaciated, with a tend- 
ency to become round-shouldered. In the male the generative organs 
diminish in size. The gait is inelastic, slovenly, mopi-h. There 
is an increasing lack of care and cleanliness about the dress and 
person. Company and companionship are avoided; seclusion is 
more agreeable. In society the deportment is shy, bashful and 
awkward. They are easily confused, and studiously avoid looking 
into the eyes of the person addressing them. 

When the ahuse is first practiced, but few of the mental and phy- 
sical symptoms will be discovered. As the habit becomes more fixed, 
the irregularities first noticed will be more manifest, and distinct, 
and others will come to the light. With the lapse of time the ma- 
jority are brought into existence and will be confessed by the con- 
trite. 

As we have before indicated, the effects of this unfortunate 
habit is depressing not only to the nervous system but particularly to 
the menial faculties. It is this hypochondriacal condition that the 
quack by his pseudo-medical works means to enhance. Aberrations 
of function never so slight, that last but a day, and perfectly normal 
processes having, in many instances, no connection with the disease, 
are described as the beginning of a train of s\mptoms horrible to 
contemplate; terminating, as their sophislry would imply, in suicide 
or insanity. Arguing, and not without some foundation in fact, that 
the majority are not guiltless respecting early indiscretions, they 
foretell " early decline," " loss of manhood," " marriage disability," 



SPERMATORRHEA. 545 

but how rarely do we me<t such results! Is it to be wondered at 
that when they fall into the hands of these vultures that an effort is 
made to increase the alarm and that upon the examination of the 
urine by the microscope (of the use of which they know little or 
nothing) they inform the victim that he is rapidly becoming imbecile, 
or, grasping the testes with some force, they venture the opinion that 
the parts are withering away? 

Their circulars and pamphlets usually comment upon the intricate 
processes necessary to elaborate the spermatozoa and their value in 
the economy (they simulate the learned), but imply that all shreds 
and flakes found in the urine are of this character. To the medical 
'student, such a fallacy is obvious. The urine of all healthy persons 
contains mucus which is increased in quantity by slight catarrh of the 
bladder or water passages, caused by some local irritation. Upon 
standing for some time in a glass, this will be observed to collect 
just ahove the bottom, in a thin white cloud. When in considerable 
quantity, it follows the urine at the termination of micturation. It 
is visible, has a whitish milky appearance and is sometimes thick 
and ropy. To the s- diments also, the attention is specially directed. 
But these can easily be tested by means both simple and always at 
hand. If « f a dark reddish color, sometimes adhering to the vessel 
and staining it, they are what are called urates, products of i lie 
waste of the nitrog< nous elements of the body. This follow s severe 
muscular exerei-e or labor and di-eases which destroy this tissue. 
Upon the application of heat they entirely disappear. If the urine 
contains the phosphates, the application of 1 eat Will precipitate it, or 
dropping in a very little nitric acid, they are dissolved and disappear. 
The urine may appear clear and yet ii' treated with heat and a little 
niiric acid it will exhibit a thickish milky substance which is albu- 
men, resembling the white of an egg. The thickish mucus that ap- 
pears at the mbuth of the urethra upon erection is misrepresented as 
being vital fluid. This is the secretion of the prostate gland and is 
discharged upon excitement, the same as the saliva of the mouth upon 
seeing a person tear to pieces a juicy and luscious peach, or other pa- 



546 MEDICAL PRACTICE. 

latable relish. It is to be noticed that none of these substances found 
in the urine are diagnostic of spermatorrhoea. Nothing is certain 
but the presence of spermatozoa, and being but the one six-hun- 
dredth of an inch in length can only be seen by the aid of a micro- 
scope. Even then it requires an experienced eye to recognize the 
lifeless spermatozoa, for other shreds and sometimes even a fibre of 
cotton which may have become detached in cleaning the vessel or 
Ihe object glass of the instrument may be mistaken by the inexpe- 
rienced. 

We do not wish to detract from the serious character of a genuine 
case of spermatorrhoea, but rather to allay the fears of that class of 
morbidly sensitive and suspicious minds which are fed to repletion 
by the ppoken and printed words of the^e swindlers. At t lines it is 
a task to distinguish the real from the false disease, and both suffer- 
er-! are alike entitled to our greatest sympathy and best counsel. It 
is the province of the physician to doctor to the mind dis< a-ed as 
well as the ailments of the body. We have never met so accurate a 
description of the mental anguish of one of this class as that of a 
clergyman suffering from emissions, and written by himself to Dr. 
Ingersoll and printed in his work : 

" The winter of 1864 witnessed great distress in my mind over the 
involuntary act by which I lost the seminal fluid. I no more yielded 
to wilfully excite my sexual feelings, but commenced a fight for 
freedom and life which lasted for eight years. From advertisements 
which fell in my way, I read statements lo the effect that the habit 
of self-abuse, producing certain symptoms which were described, 
and which I thought I saw in myself, would result in loss of health, 
in idiocy, or insanity. I never applied for help to any of these ad- 
vertisers, nor took any drug of any kind for my cure. It seemed a 
shame for me, a Christian, to have such feelings, yet I prayed to 
Cod with' 'lit ceasing, and trusted in him with all my heart. Con- 
vinced that involuntary action of any sort was not guilty, I held fust 
the profession < f my faith without wavering, and finding my inteu- 
tentions pure toward God and men. I suffered on in faith. 



SPERMATORRHEA. 547 

" The struggle went on, a struggle to overcome and crush out of 
me what seemed the remains of the carnal nature. Day and night 
the one thought was ever present, and my prayers centered on this 
longed-for deliverance. I set apart clays of fasting and prayer, and 
wept bitter tears of sorrow at the desolation which seemed to 
be coming upon me. I plead with God that he had called me to the 
Gospel ministry, that I longed to enter it for his honor and human 
salvation only, that it must be a triumph against Christ's kingdom if 
Satan ruined my body and mind. All the while I was achieving un- 
usual success in study." (Note that!) "Sometimes I would get a 
• great uplifting, and for two or three weeks would not have a semi- 
nal emission. Then, jiist as I thought deliverance had come, again 
I would be put to shame. Strange that never in all these years did 
I think of my sexual powers as having any such relation to the atone- 
ment as I accorded t > tiie powers of my mind; strange that I never 
asked Christ to save them but only to destroy them. 

'■ During this time, as my powers of mind and spirit grew, my 
sexual feeling asserted itself stronger and stronger. Yet it was never 
nourish^ d by indulg nee of any sort. I never told impure stories, 
nor would I listen to or tolerate in my presence any reference to the 
powers or functions of sex, nor amthiig which I regarded as un 
clean. All this lime I was experiencing the states : nd conditions of 
inward peace, growth, and joy which distingu shed me among my 
fellow beli vers as a happy even tempered Christian. I never had 
the blues, never d<spaired." (Renarkable!) 

"But the struggle was fearful; the night long. And attending 
these efforts were frequent failures, which so dishearten the struggling 
one, that opportunities are allowed to p iss unimproved that are full 
of results, if only made the most of as they fly 

" The society of the best women I enjoyed very much indeed, but 
was not often in company, for after such association I felt a sensible 
weariness of brain, as if it were sore, from its strong action in self- 
control. Yet there was not the least desire to violate their chastity; 
from this I was wholly saved : "but I felt that association with them 



548 MEDICAL PRACTICE. 

ought to be entirely independent of thoughts of sex or bodily emo- 
tions « f sexual feeling, an association of mind and heart wholly in- 
dependent of body and sexual differences. 

" After eight years of such struggles, I felt that a crisis had come 
in my life. At this juncture I communicated with an eminent phy- 
sician, asking him if there was any help for me. He told me that 
my trouble, sexually, arose from my brain, which was over full of 
blood. The seminal emissions were the work of Nature to reli ve 
the pressure on my brain, and unless I had them, I might have had 
ai oplexy. The nerves of the back brain, governing the sexual func- 
tions, being stimulated to undue activity by the presence of too 
much blood, must have rest, and as all mental work induced the 
flow of blood to the brain, I must stop studying and preaching until 
the harmony of the circulation could be restored: then my cold 
feet and legs would become warm, and my hot head would lose its 
excessive heat. 

" With him I remained seven months, experiencing many kind- 
nesses and some benefit, but my emissions still continued at intervals. 
I was told by the associate physician that when my digestion was so 
improved that I was able to make strength faster than II st it by the 
seminal emissions, then I would not be weakened by them and would 
be practically well." Subsequen ly the author gave him the follow- 
ing information and instruction: "All your life you have been 
sorely grieved and well nigh angry with yourself that you were a 
man. Instead of having your whole bo-'y full of light, you have 
reckoned the sexual part of it dark, have had a horror of the same, 
have hidden it away from your prayers, consecrations and thoughts. 
All else in you, the power to think and reason, ihe power lo love 
and trust, all other of your ph) sical \ owers you have specifically 
offered to Christ and devoted to holy uses. But the sexual power 
you have left outside and battled with. You give thanks when you 
have spiritual desires and pray that they may be satisfied in God; 
for desires after knowledge also, and give praise for all good thoughts; 
BO also when you have a good appetite for food you thank God and 



SPERMATORRHOEA. 549 

pray for the government and satisfaction of that appetite. Now when 
you have sexual feeling and sexual desire, do the same. Commit all 
to Christ for his government. Praise him for the gift and leave all 
subject to His control. Do not fear that you will become lustful and 
ungovernable. What Christ governs is not ungoverned. Because 
conscious of your muscular power and rejoicing in your strength, 
you do not feel desirous of beating your neighbor — nor can you, if 
governed by Christ's law of love, ' for love worketh no ill to his 
neighbor.' Neither when money, not your own, is within your 
grasp, will you have any disposition to steal it, — though you value 
and prize money as a means of power, usefulness, and gratification — 
because the law of love says, 'Thou shalt not steal.' Again, you 
are conscious of sexual power, sensible of the desires associated with 
a healthy sexual nature. While rejoicing in it, you are in no danger 
of dishonoring yourself or another, provided you put it with all the 
other desires which Christ controls and trust to His care. You have 
intense desires after knowledge, and often feel the spring of the 
powerful force seeking to know. For this you give thanks, yet be- 
cause you value and love this power, are you any the more in danger 
of seeking knowledge of evil, the ways of evil men, the society of 
impure minds? By no means. The trouble with people is that 
they put all the rest of the powers into one class-— the salvable class, 
and put sex by itself as essentially different, unholy and unsalvable. 
He who made the body, no doubt controls all its involuntary condi- 
tions." The clergyman then continues his narrative: " My emis- 
sions did not cease, but I felt well. My old habits of thought did not 
at once give full place to my new convictions, but yielded steadily to 
the renewing power of Christ. Now my mind was easy. The dread 
of insanity which many times follows the continuous strain of mind 
attendant upon such a conflict as I had passed through, was wholly 
removed. A sense of perfect security in Christ filled my mind, and 
as I am writing not only past but present experience, I may say fills 
my mind continually." 
We wish to make a few critical comments. He was " convinced 



650 MEDICAL PRACTICE. 

that involuntary action of any sort was not guilty," yet this convic- 
tion was not strong enough to stamp out the poison imbued by the 
" advertisements which fell in his way." The emissions were natu- 
ral, as we have described in the previous essay. If not, could he 
have " achieved unusual success in study ?" The " upliftings " would 
have been of longer duration, if he had taken the necessary steps 
to secure it. The depression, as it was, was more visionary than 
real. The instructions of the ' ' eminent physician," if not correct, ap- 
pear philosophical. Still " the emissions continued at intervals," for 
"seven months." Mental labor without physical exercise, by ener- 
vation of the nervous system certainly predisposes to emissions. He 
concludes; " my emissions did not cease, but I felt well." "Now my 
mind was easy " and " a sense of perfect security fills it continually." 
In short, the truth is, he never had spermatorrhoea. But he thought 
he had it, and as the case is similar to thousands of others, we have 
introduced it to show that, when ill-advised, a spectre may haunt the 
most intelligent for " eight long years." The transition from one 
state of mind to the other, however, was gradual, not precipitate. 
Tuis mental and nervous depression of years' standing requires the 
best, most intelligent and tender care. An old adage runs: " We are 
men, and nothing that affects humanity should be a matter of indif- 
ference to us." H< re is wide ground for sympathy. Neither com- 
mands nor ridicule w ill answer. 

"No:hing surely can surpass the inhumanity, as well as the folly, 
with which patients of this class (sufferers from nervous disease) are 
too frequently treated. We often act upon the ill-founded idea that 
such complaints are altogether dependent upon the power of the will; 
a notion which, in paradoxical extravagance, s arcely yields to the 
doctrine of a modern, though already obsolete writer on 'The Phi- 
losophy of Morals,' who asserted that no one need die, if with a suf- 
ficient energy he determined to live. To command or to advise a 
person 1 tboring under nervous depression to be cheerful and alert, is 
no less idle and absurd than it would be to command or advise a per- 
son under the direct and most intense intluence of the sun's rays, to 



STEEMATCBTECEA. 551 

shiver with cold, or one who is ' wallowing in December's snows ' to 
perspire from a sensation of excessive heat. The practice of laugh- 
ing at or scolding a patient of this class is equally cruel and ineffec- 
tual. No one was ever laughed or scolded out of hypochondriasis. 
It is scarcely likely that we would el vat e a person's spirits by in- 
sulting his understanding. The malady of the nerves is, in 
general, of too obstinate a nature to yield to a sarcasm or sneer. 
It would scarcely be more preposterous to think of dissipating a 
dropsy of the chest than a distemper 01 the mind by the force of 
ridicule or rebuke. The hypochondriac may feel, indeed, the edge 
of satire as keenly as he would that of a sword; but, although its 
point should penetrate his bosom, it would not be likt ly to let out 
from it any portion of that noxious matter by which it is so painfully 
oppressed. The external expression of his disorder maybe checked 
by the coercive influence of shame or fear; but, in doing this, a simi- 
lar kind of ri k is incurred to what arises from the repelling of a 
cutaneous eruption, which, although it conceals the outward appear- 
ance, seldom fails still more firmly to establish the internal strength, 
to increase the danger, and to protract the continuance of .the dis- 
ease." — (Dr. Reid.) 

Trusting the digression may be of interest and value to the reader, 
we will resume the subject. 

"A knowledge of the extent," remarks Dr. Howe, "to which the 
habit of self-p llution prevails would astonish and shock many. The 
above remarks apply to all of our public schools, for I have become 
too well acquainted with the alarming extent to which it prevails, 
often in the most open manner; the extent of it is amazing, for it ex- 
ists both among the teachers and students. There are cases record- 
ed where servant women who had charge of little girls, deliberately 
taught them the habit of self-abuse in order that they might exhaust 
themselves and go quietly to sleep. This has happened in private 
houses as well as the alms-houses. Female factory operatives prac- 
tice it to an alarming extent ; even little girls abuse themselves. A 
lady said a little girl in her neighborhood had just died from its ef- 



552 MEDICAL PRACTICE. 

fects, and that the female operatives in a neighboring factory prac- 
ticed it almost universally, as she learned from one of them. She 
named other factories in which it was hard y le-s prevalent. Little 
girls below their teens thus abus : themselves, and ihe practice is 
alarmingly extensive among the fairest portions of creation.'' 

There is more liabiliiy to be deceived in girls than in boys, because 
neither parents nor members of the family, nor in fact the physicians 
are at liberty under the laws regulating the social relations of the 
sexes to exercise as frank, free, and full inspection and examination 
into all the causes that produce disease among females as they are 
among male-*. 

A mother is always more familiar with her son than a father is 
with his daughter in the direction of any conditions that may grow 
out of their respective sexualities. Owing to this, masturbation is 
practiced with more unsuspiciousness by girls than by boys, especi- 
ally at or about the age of puberty. If at that period a girl shows 
any infirmity, feebleness, lack of vigor, or anything of that sort, the 
mother has all her attention directed toward the development of the 
menstrual function. She is afraid that the child who is getting to be 
a woman is likely to fail in the upspringing of this new activity and 
to have in consequence a sick turn. She proceeds to doctor her 
daughter, if doctoring is the order of the day, from the standpoint 
of preconception. In a large number of cases, what is supposed to 
be the derangement of the menstrual function consequent upon a 
girl's arrival at puberty, as shown in her illness or perhaps severe 
sickness, should 1 e attributed to a habit of rousing up by artificial 
means her sexual organ'sm to unnatural excitement, the reactionary 
effect! of which are seen in her morbid states of body, and about 
Which her par nts and friends are so often alarmed. Let it be borne 
in mind, then, by pan nts whenever such particular, unnatural or 
unaccountable conditions of appetite show themselves as we have al- 
luded to — in fact, when any very strange alimentative caprice is ex- 
hibited by a boy or girl for which there is not the most obviously 
plain interpretation at hand, the exposition of it is to be had only by 



SPERMATORRHOEA. 553 

and through the acknowledgement of the fact that the party is to be 
classed among these unfortunates. 

In girls and women the consequences of this vice differ somewhat 
from those in men. There is the excitement, but of course unattend- 
ed with the loss of the spermatic fluid. The effect is noticed in the 
prostration of the nervous energy and in general debility. The gland- 
ular system suffers and the breasts are only partially developed. 
There is a tendency to become round shouldered, the upper part of 
the body pitching forward, while there is a sinking in of the abdo- 
men. Eventually, as in the male, they become poor in flesh, bashful, 
disliking the company of others, particularly of the opposite sex. 
The face is pale, with dark circles under the eyes and the customary 
eruption upon the cheeks, chin or forehead. 

The effects of bad habits are peculiarly exhausting upon constitu- 
tions tending to consumption or insanity. Marital excesses, it may 
be here remarked, have a similar influence and to an equally intensi- 
fied degree. Several instances have come under our special notice 
where one of the parties in wedlock rapidly declined after its 
consummation. Dr. Smith of England, as long ago as 1862, upon 
inquiry into the numerous condiiions affecting the constitution in one 
thousand consumptives declared that over 11 per cent, of the males 
had committed sexual excesses; over 18 per cent, had been addicted 
to masturbation and 22 per cent, had suffered from involuntary 
emissions. Where properly advised, the immediate danger passed, 
but we fear the prostrating results have never been completely obli- 
terate d. It is a fact worthy of especial attention that many diseases, 
particularly those affecting the blood and nervous system, can be 
traced to this as the sole cause, and the treatment of them will be 
unsuccessful by the physician who overlooks this, or the invalid who 
disregards it. 

We occasionally are informed that marriage has been professionally 
advised and in some instances consummated. Such counsel is irra- 
tional and the ultimate results are extremely pitiful. Lallemand 
inquires: "What has the young girl, who is thus sacrificed to au 
24 



554 MEDICAL PRACTICE. 

egotistical calculation, done, that she should be condemned to the ex- 
istence that awaits her ? Who has the right to regard her as a thera- 
peutic agent, and to risk thus lightly her future prospects, her repose, 
and the happiness of the remainder of her life ?" An additional stimu- 
lus is given the organs already diseased and exhaustion follows, until, 
as described by the same author, "little by little, the phenomena of 
excitement which precede the orgasm diminish and at last com- 
pletely disappear; the emission then occurs without dreams, without 
erection, without pleasure and even without any particular sensa- 
tion; in fact, the patients are not aware that emission has taken 
place except by the stains they observe on the linen when awake. 
At the same time the seminal fluid loses by degrees its consistence, 
its color, its smell, and resembles most closely mucus or prostatic 
fluid." The man is wrecked, and the woman, to say the least, mor- 
tified if not hopelessly disappointed. "It is precisely because 
marriage is the most sacred bond for individuals, as well as the most 
important for society, and because an iron law renders it indissolu- 
ble, that it is rational as well as moral not to contract it without the 
certainty that it will be i erfect and complete." 

TREATMENT. 

The successful treatment of spermatorrhoea will depeud, in a great 
measure, upon the adoption of means best fitted to the particular 
case and individual, the thoroughness with which these means are 
employed and the perseverance necessary until a cure is completed. 
In a general manner we will discuss these under four divisions, viz : 
mental, surgical, hvgienic and medicinal. 

Mental Treatment. — Be determined to get well. This will be dif- 
ficult at first, but " practice will make perfect." As soon as self-abuse 
or excess* 8 are stopped emissions will happen frequently, disclosing to 
the surprised invalid the weakened condition acquired by these 
organs. Bring the will, however, to bear in controlling and avert- 
ing emissions by rousing at the first indication, either feigned or 
apparent. Be chaste in word and thought. 



SPERMATORRHOEA. 555 

What impairs the mental and moral faculties still more than the 
loss of seminal fluid is a certain reveling in lascivious fancies, which 
is the more dangerous, the more secretly indulged in and the 
younger and feebler the persons addicted to such excesses. The 
higher functions of the soul are almost destroyed by them; all the 
purer and nobler thoughts are constantly superseded by the imagery 
of a libidinous imagination. This unnatural indulgence affects the 
sensorium, the spinal marrow, digestion and nutrition. By the 
time the patient is made aware of his error all these phenomena have 
made a more intense development. The effect of these silent trans- 
gressions is the more formidable the younger the culprit and the 
weaker his constitution and the desire to discontinue his evil prac- 
tices. No abuse is fraught with more destructive consequences than 
this. 

Carpenter, in his Physiology, gives unmistakable advice: — "The 
author would say to those of his young readers who urge the wants 
of nature as an excuse for the illicit gratification of the sexual pas- 
sion, ' try the effects of close mental application to some of those en- 
nobling pursuits to whicli your profession introduces you, in combi- 
nation with vigorous bodily exercise before you assert that the 
appetite is unrestrainable, and act upon that assertion. ' Nothing tends 
so much to increase the desire as the continual direction of the mind 
toward the objects of its gratification, especially under the favorable 
influence of sedentary habits, whilst nothing so effectually represses 
it as the determinate exercise of the mental faculties upon other sub- 
jects and the expenditure of nervous energy in other channels." 

Surgical Treatment. — When the prepuce or foreskin is so 
lengthened as to hide from view almost completely the glans, or when 
it covers the glans so tightly that it is impossible to uncover by draw- 
ing it aside, or when this can only be accomplished with difficulty, 
circumcision is advisable. This is accomplished by drawing the 
superfluous skin well forward, holding it in a vise kept close to the 
glans and with one cut removing all beyond. The clamp is then 
removed and the edges held to each other by stitches until healing is 



556 MEDICAL PRACTICE. 

completed. In the case of constricted skin (phimosis), it is some- 
times sufficient to clip the constricting bands, in several places, whn?h 
frees the foreskin at once. Before this is done the question of super- 
fluous skin should be decided upon, for it is unnecessary in any case 
to perform both operations. A thin bladed knife is slipped between 
the two and then turned so that the cutting edge cuts against the con- 
stricting bands. The cut is not deep, and by the finger pressing from 
the outside against the edge of the knife, the operator can, by feel- 
ing, facilitate his work. 

"While the above removes extreme sensitiveness of the glans, it has 
no effect upon a similar condition which may exist in the urethra. 
This is best relieved bypassing into the urethra once or twice a week 
a flexible catheter or a bougie having an olive-shaped tip. Some 
pain is usually experienced while the instrument presses upon the 
sensitive parts, which are located about six inches from the orifice. 
Tn is disappears as the inflammation is removed and with it the fre- 
quency of emissions. 

When possessed of an electrical machine, the above may be im- 
proved upon by using the steel sound. This is curved like the canal 
and is inflexible. It should, like all instruments, be well oiled before 
use and passed into place slowly and with the greatest care. When 
in place, an electrical current can be passed along the instrument, the 
p sitive pole being applied to the handle and the negative moved 
about in the region of the point. Its use for too long a period atone 
siting is weakening. 

When sufferers complain that, with the best intentions, they are 
not able to cease the pernicious habit, or that they find themselves in 
a semi-conscious and dreamy condition involuntarily performing the 
act, we know no better assistant than that afforded by such an irrita- 
tion of the parts that manipulation will be impossible. This is 
effected by applying a c unci's hairbrush wet in tincture ot'eantharides 
(Spanish-fly), upon different parts of the organ, allowing intervals of 
healthy skin between. The application may also be made by wetting 
small strips of cotton in the tincture and tying them on at intervals, 



SPERM ATORRHCE A. 557 

allowing them to remain until blistering begins. As these parts heal, 
the intervening parts should receive the same treatment. This course 
is applicable to both sexes, may be termed harmless, and gives the 
patient a good foundation for following some of the methods here- 
after mentioned. 

Hygienic Treatment. — This may be concisely stated to be the 
use of such means as will improve all the functions and tone up the 
system. First among these are exercise and diet, outdoor sports and 
gymnastic exercises when possible, and if not, such light labors as will 
employ the body and not tax the mind. A good plan for the seden- 
tary is to exercise at least fifteen minutes morning and evening, with 
Indian clubs and dumb-bells. These can be had at most of the hard- 
ware stores in our large cities, or, if preferred, the clubs can be 
roughly made at home. The weight of a single club should not ex- 
ceed six pounds. A neat and convenient apparatus, which meets 
every requirement, is the Parlor Gymnasium, which is explained on 
other pages. Long walks, running, and horseback riding, seem to 
be contra-indicated. In no case is exercise to be continued to fatigue. 
Many suppose that when exercise is advised, it must be violent or 
protracted. Excess is not only without salutary effect, but detri- 
mental. 

The diet should be plain and nutritious. Stimulants, which in- 
cludes much meat, eggs especially, spices, malt and alcoholic liquors 
and tobacco in every form, are prohibited. The last meal of the day 
should be light and with but little fluid, in which are included juicy 
fruits and vegetables. 

The bed coverings and clothing about the hips should be light. 
Feather beds, particularly, are overheating and stimulating to the 
pelvis and generative organs. Lie upon the sides but never upon the 
back. For those who are in the habit of sleeping upon the back 
considerable assistance will be rendered by tying a wooden ball in a 
long strip of cotton, which should be fastened about the waist suffi- 
ciently tight to prevent slipping, having the ball pressing upon the 
spine, or a spool or a stiff brush may be tied in a similar manner 



558 MEDICAL PRACTICE. 

with a cord. While this prevents an injurious position in bed, it 
necessitates rising to a sitting position in order to turn from side to 
side; besides, such adjuncts are likely to cause more or less restless- 
ness when first adopted. 

The bladder should be emptied before retiring, and again in the 
niijht, if discovered full. At such a time do not wait but arise at 
once. The bowel ■< should be kept soluble and evacuated daily. 

If restless towards morning, rise at once, take a cold bath, and 
occupy the mind by reading. A second sleep is dangerous. Most 
emissions occur early in the morning. 

Bathe the body, including the genitals, daily; if in the morning, 
with cold water, if at night, with warm. Dr. Jacobi, in a mono- 
graph, remarks: "The good habit of washing young children in 
cold water is not always unattended with a certain degree of danger. 
There are some that are unduly excited by it at bed-time. In adults 
I have frequently observed that, while cold washing of the whole 
body — genitals included — would be attended witli good results in the 
morning, it, or the cold shower-bath, just before going to bed, would 
lead to excitement and nocturnal emissions;'' and adds: " This obser- 
vation has led me to pay some attention to the possible ill-effect of the 
same dietetic treatment in the evening, in the cases of such children who 
were known as, or suspected of, being addicted to the morbid habit." 

Medical treatment. — When there is a tired, aching feeling in 
the testes, or varicocele, or the scrotum is lax, particularly in the sum- 
mer, a suspensory bandage should be worn. This affords much 
comfort to the wearer. 

To insure protracted sleep, bromide of sodium may be taken at 
bedtime. We prefer a pill made of 

1}. — Lupulin, 1 ._*•_« 

, , , r one srrain of each. 

Camphor, j Mix 

Or, 

I?. — Lupulin, two grains, 

Gelseinin, one-fourth grain. Mix. 



IMPOTENCE. 559 

These are slightly narcotic and anaphorodisiac, dissolve slowly, 
and have a protracted effect. They leave no deleterious effects upon 
the system. For a corroborand effect upon the digestive organs, take 
if necessary some of the bitter principles, such as a combination of 
hydrastin and pepsin. To improve the nervous and muscular powers 
we recommend the use of 

I£. — Phosphorus, . . . . . one grain, 

Extract of Nux Vomica, . . . twenty-five grains. 

Add sufficient fat and make one hundred piJls, One to be taken 
immediately after breakfast and dinner. These should be made by 
a pharmacist, as they require great care in manipulation. 

Only cases of long standing require medication, and then only for 
a sufficient length of time to bring the system to such a condition . 
that it may, of its own accord, continue recuperative action with- 
out it. 

Impotence. 

When abuse, either from excesses or masturbation, is continued 
beyond the point above indicated, we have impotence. From this to 
dementia is but a few steps. Lallemand furnishes the following defi- 
nition: " Impotence consists in want of power in connection, not 
once, but habitually; not only with courtesans, but with those whom 
we most love ; not under unfavorable circumstances, but during long 
periods of time, as five, fifteen, or twenty years, when married to 
lovely and handsome women whose devotion to their husbands has 
never been questioned." The fact is evident that bad habits do not 
injure in the demand upon the elaborated and vital secretion known 
as semen, but directly by the spasmodic excitement and exhaustion 
of the nervous system. Women do not secrete semen, and yet those 
of this clas* suffer to the same extent as men. In treating this sub- 
ject we will not mention malformation, the pressure of trusses used 
in relieving hernia, the enlargement of the veins of the cord, stricture, 
and corpulency, that are physical causes of this condition. 



560 MEDICAL PRACTICE. 

It is often asked: How may I know when I am overreaching 
moderation? We use the language of the last i.araed author. " When 
connection is followed ly a j- yous feeling as well as fresh vigor, 
when ihe head feels more free and easy, the body more elastic and 
lighter; when a greater impetus to exercise or intellectual labor arises 
and the genital organs evince an increase of vigor and activity, we 
may infer that an imperious want has be< n satisfied within the limits 
necessary for health. The happy influence which all the organs ex- 
perience is similar to that which follows the accomplishment of every 
funclion necessary to the economy ;" or, putting it in other words, 
Mr. Acton says: " Wlien coitus is succeeded by langour, depression 
of spirits and malaise, the individual may consider that he has com- 
mitted an excess." 

The disease is one of ihe nervous and muscular systems and is es- 
pecially sad and deplorable in either sex. The influence of the mind 
is an important factor in producing a condition closely resembling the 
true t iseasc ; but the difference is soon discovered,as it is but temporary. 
Ui divided and prolonged attention to intellectual matters and pro- 
tracted muscular exertion may develop temporary impotence. So, 
also in the young, the consciousness of abuse, unfounded fears ihat 
the act will be unsatisfactory, sudden alarm or any noise or accident 
that diverts the attention, all have a similar effect. Sexual apathy is 
in many cases of this nature, and the pariy of either sex rinds more 
pleasure in the practice of the morbid habit continued from youth. 

TREATMENT. 

Any treatment that will insure restoration must be unstimulating. 
The use of those remedies which increase the sexual appetite are but 
temporary in character and effect, and are followed by disaster, leav- 
ing ihe organs worse than before. A wise and judicious treatment 
will consist in first removing the physical causes, if any exist, the ap- 
plication of such surgical means as are necessary, and the continued 
use of hygienic medical means. Most of the treatment that we have 
noticed as applicable to spermatorrhoea is valuable in impotence. 



VARICOCELE. 561 

Especially is this the case in the use of the phosphorus and nux pills, 
which are roborant both to the muscular and nervous systems. 

Inflamed Testicle, Swelled Testicle.— Orchitis. 

The testicle is likely to take on inflammation from specific disease, 
from injury or pressure, from metastasis of mumps, and from colds. 
It increases in size rapidly, the pain is severe, and walking is hin- 
dered if not rendered impossible. Efforts are continually made to 
support the parts. As the inflammation increases, pains shoot up 
the groin into the abdomen and sometimes down the thighs ; fever, 
nausea, and vomiting set in. If not promptly relieved, suppuration 
may occur or permanent enlargement. 

TREATMENT. 

The sufferer must go to bed. If there is fever, give a spirit- vapor 
bath. Pack the testicles with cloths wet with a warm and strong solu- 
tion of muriate of ammonia. A better remedy is a compress wet 
with tincture of belladonna; this will remove the inflammation in a sin- 
gle day. The testicles must be brought well up upon the abdomen 
and there supported eith/ r by a sling or by strips of adhesive plaster 
which secure immobility. If necessary, shave off the hair. It will 
be well to wear for some time after recovery a suspensory bandage ; 
especially if the disorder happens in the summer time. 

Varicocele 

Is an enlarged condition of the veins of the spermatic cord and 
scrotum. The left is the one more commonly varicosed. The swell- 
ing begins from below and extends upward. The scrotum becomes 
weighty, pains shoot along the course of the cord and walking is at- 
tend d with much distress. The veins give to the touch the feeling 
of a twisted or knott} r cord. 
21* 



562 



MEDICAL PRACTICE. 




PCKOTAL SUPPORTER. STRONG AND DURABLE. 
TREATMENT. 

A ready means of relief is the use of the 
suspensory bandage. If the testicle is 
enlarged or the parts are swollen, better 
use a scrotal snpponer. The radical cure 
is effected by surgical operaiion. The veins 
are carefully separated Jrom the arteries 
and cord. and tied withcarbolize-1 catgut or 
severed at once and allowed to bleed, con- 
trolling the hemorrhage by pressure. With- 
in three da\ s the wound lias healed and in 
a week the person can resume business. 




susp'y ban-page, lighter 
and for summer wear. 



GONORRHOEA. 563 

Sarcocele is a fleshy tumor of the testicle. It may he henign or 
malignant. The cancerous disease is fortunately rare. In this case 
the growth is hard, heavy, increases in size, becomes more and more 
painful, finally opens in ulcers and so involves the whole system that 
the person has the characteristic look of the cancerous ; a pale and 
anxious countenance. As soon as its malignant character is sus- 
pected, castration should be performed. 

Clap. — Blenorrhcea, Gonorrhoea, Bubo. 

This is an infectious disease, consisting of a catarrh of the urethra 
(the discharge pipe of the urine) in either sex attending an inflam- 
mation of the mucous membrane lining the canal. The discharge 
through venereal excitement of slight transparent exudations from the 
meatus or mouth is the only instance where excessive mucus is nor- 
mal or natural. All else is pathological or diseased. It affects also 
the prepuce in the male and the vagina ia the female. In the major- 
ity of cases it follows connection with one so_ affected, but not invar- 
iably. The exceptions occur when the urethra is uncommonly sen- 
sitive and arise from mechanical injuries from the use of the catheter, 
from intercourse during the menstrual period and from acrid leucor- 
rhceal discharges. Of course, we also except the rare instances 
where the poison is accidentally received by the use of public urinals 
or closet seat*. The prominent feature of the disease is a discharge 
from the privates of aa irritating matter, a poisonous pus. This 
specific matter or other poison finds lodgment upon the mouth of the 
urethra or the folds of the mucous membrane and sets up an irrita- 
tion. If, in from two to seven days after exposure, the inflammatory 
action has so far progressed that a discharge of catarrhal mucus com- 
mences, it is a certain sign of inoculation. 

The potency of the poison is very great, similar to vaccine matter, 
to which it is closely allied, the least particle of which reaching the 
true skin produces vaccination. 

In a public hospital in Cincinnati, although great care was taken, 
all the convalescent patients of a single ward were attacked with the 



564 MEDICAL PRACTICE. 

disease by ihe introduction of a single party who endeavored to con- 
ceal his affection. This contagion came from using the same urinal, 
and the guilty party was only detected by searching his wardrobe in 
his absence. 

The virulency of the non-specific virus is sometimes surprising. 
Its effects are commonly mild in character, as far as the physical sys- 
tem is concerned, but if the chastity or fidelity of the partner in wed- 
lock is questioned, there may be a storm in the social atmosphere. 
The position of passing judgment in such cases is a delicate and re- 
sponsible one for the physician, but if he be intelligent and the facts 
warrant, he can dispel the clouds of doubt and restore confidence and 
harmony. A knowledge of the above-noted conditions which pro- 
voke this form of gonorrhoea will satisfactorily explain its appear- 
ance, and we trust, lead to avoiding them. 

This discharge though non-specific is contagious — may be trans- 
mitted to the opposite sex. Prof. F. N. Otis says: "I have seen 
several cases which go to prove that a contagious secretion from the 
mucous membrane may be present as the result of simple causes, 
wholly independent of contagion." A stricture of the canal, of long 
standing that has not been perfectly cured may at the time of mar- 
riage produce this catarrh in the male and inflammation of the vagina 
in the female. We have seen leucorrhoea in a child five or six 
years of age. which was produced by the presence of pin worms in 
the bowel. These were entirely removed and yet the discharge con- 
tinued. This poison was carried to the nose, mouth, and eventually 
the eyes, causing that terrible disease gonorrhoeal ophthalmia or in- 
flammation of the eyes. In spite of the greatest camion commanded 
and the exhibition of the extremest care in manipulations, the mother 
after caring for the child accidentally used the same towel and was 
herself attacked. 

Symptoms : — The disturbance is local and general and is graded 
very much by the nature of the cause. From mechanical injuries 
or leucorrhceal discharge, the inflammation may be slight and but a 



GONORRHOEA. 565 

limited quantity of clear or slimy mucus escape. When the cause 
is specific feverishness, thirst, coated tongue and constipation may 
follow ; a burning sensation aud afterward severe scalding pains on 
passing urine, swelling of the glans or head of the member and pain- 
ful spots in each groin. This local difficulty in the groin (bubo) is 
due to the fact of the absorbing glands taking up the poison and 
suffering consequent irritation, and it may be, inflammation. These 
lumps should not be handled; we have seen th m from imprudent 
manipulation increase in size in twenty-four hours from that of a 
pea to that of a goose egg. If the inflammation continues to spread, 
there are frequent and painful erections and continual desire to 
micturate and defecate. The prostate gland may inflame, causing 
prostatitis, or the testicle causing orchitis, and even the kidneys may 
become involved. Stricture is a not uncommon sequel. In the 
female it may spread to the bladder and womb. 

The indications are to relieve the inflammation which is local as 
soon as possible. In case of constitutional symptoms the treatment 
advised for syphilis should be adopted. 

TREATMENT. 

In mild cases we prescribe injections of warm milk into the 
urethra after each passage of urine, In general, we have prescribed 
for years, a solution of 

1$. —Sulphate of Zinc, .... two drams, 
Fluid extract of Golden Seal, . . one dram, 
Glycerine, ...... two ounces, 

"Water, two ounces. 

Mix. 
Add to a teaspoonful of the mixture a teaspoonful of hot water 
and inject three times a day after urinating. The urethra should be 
closed above by pressure of the finger and thumb to prevent the 
medicine passing the entire length of the canal. This precaution is 
necessary to avoid the lodgment of some of the virus upon the healthy 
surface. From the difficulty experienced in carrying out this plan 



566 MEDICAL PRACTICE. 

and from a conviction that the injections amount to but little more 
than temporary baths, these means have been superseded by the use 
of bougies. Here the remedy remains in contact with the evil all lhe 
time it takes to dissolve, about two hours, aud as much longer as it 
is retained. The convenience in carrying, the ease in introduction 
and the (fficiency in service, recommend them. The imported ;iriicle 
is known as Portc-rcm^ :li Beynal. A very soluble gummy compo- 
site is the basis aud they are medicated with opium, belladonna, sul- 
phate of zinc or chloride of zinc in different proportions to meet 
various cases, being soothing, tonic, ast ingenc or caustic. One is in- 
troduced at night upon retiring; some imc> two applications are 
necessary, ouc at night and one in the morning. The bougie is 
dipped in water and immediately withdrawn, which renders it oily 
enough for easy and painless introduction. 

Gleet. — This follows improperly tre .ted or neglected gonorrhoea. 
It is a continuous discharge of colorless slimy mucus, small in quan- 
tity and without pain or scalding. It is obstinate in treatment, and 
may be the forerunner or concomitant of stricture. Treatment by the 
astringent or caustic bougies Reynal, meets every indication and 
almost uniformly results in speedy recovery. 

Stricture of the Urethra. 

This term is applied to a lessening in the size or calibre of this 
tube; hence we have interference with the discharge of urine, which 
appears in diminished quantity, is expelled with difficulty and in a 
forked or spiral stream, sometimes only by dribbling or in drops. 
This may be permanent or transient. The former is due to a change 
in structure, — the latter may be only a nervous affection. We have 
simply to do with the permanent disorder. From inflammation in 
the tube, usually gonorrhceal, or from accident, there is a thickening 
of its walls and the presence of lymph, which hardens as the inflam- 
mation recedes, forming a continued pressure at the point of partial 



STRICTURE. 567 

closure. The stricture does not occur in a continuous line along the 
canal, but at points, leaving the healthy or dilated canal between. 

Apart from the symptoms, the surgeon requires the additional 
knowledge furnished by local examination. An elastic catheter, with 
a pear or olive-shaped point, is slowly passed through the tube. At 
points of stricture its progress is retarded and sometimes entirely 
stopped. The greatest care must be observed in this exploration, for 
if any force is used the diseased part may give way under the pres- 
sure and the instrument lose the canal entirely. The invariable rule 
should be, use no force whatever. A smaller sized lip will often be 
successful Sometimes the opening will be a lit leout of the dir<-< t 
line, when a slight change in the hand of the manipulator will permit 
its further passage. There are cases in which the line is so tortuous 
that it is simply impossible to r< ach the bladder. 

TREATMENT. 

The treatment of spasmodic stricture is simple and sometimes re- 
quires nothing but diversion of the mind. A dash of water in the 
face will be followed with a copious stream. The permanent is often 
aggravated by spasms. Hot fomentations, the use of gelsemi um or 
lobelia, the steam bith, being alone, the noise of running water, sepa- 
rately or altogether, overcome the spasmodic form. 

In treating permanent stricture caustics should be avoided, for inva- 
riably their use aggravates and even produces the disease. The most 
desirable method of cur .; is dilatation. A s eel sound, small in size, 
may be introduced and allowed to remain a few minutes. This ope- 
ration may be repeated two or three times daily. The instrument 
can then be laid aside and a larger one emp'oyed. In every ca e a 
small amount of sweets >il should be injected before the instrument 
is introduced. Instruments are employed which, arriving at the stric 
lure, can be enlarge 1 by force, tearin r tie fibres apart. Inflamma- 
tion sometimes fo lows, and, in every instance, the sound must be 
u«ed to obtain lasting benefit. 

Another method more speed*- in its application and taking less 
time in healing, is that of incision ; but this requires the surgeon's 



568 MEDICAL PRACTICE. 

help. A pointed rod, but having an edge, is introduced from the 
surface at right angles with a sound in the canal directly to the 
point of stricture. In parallel lines the constricting bands are sev- 
ered. The knife can thx n be removed. The bl.de and shaft are so 
small that the wound upon the surface has the appearance of a punc- 
ture with a large needle. The instrument can then be used on the 
side opposite to that previously engaged. 

When the stricture is seated far back in the tube, close to the pros- 
tale gland, the operation is similar to that for stone in the bladder, 
free incision is made through the perineum. 

Circumcision. 

This operation is confined in this country almost wholly to the male 
infants of Israelites The custom is of ancient origin and is consid- 
ered as, or associate.! with, religious ceremony. Whether the origi- 
nal object of this mutilation was cleanliness or exemption from spe- 
cific disease, which the circumcised possess to a remarkable extent, 
we are unprepared to state. Many natioi shave practiced it and mil- 
lions of people at, the present day adopt the custom. A description 
O* this simple operation may be of intrrest and perhaps of service. 
All that is required is a sharp knife, a guard and narrow piece of 
lint for a dressing. The guard may be any device that will firmly 
hold several tlrcknesses of skin, and at the same time present on one 
side an even surface to allow the fiat side of a knife-blade to slip 
along without catching. The instrument consists of two flat pieces 




CIRCUMCISION FORCEPS. 



of metal, ivory or wood, fastened with a hinge or dowels. The pre- 
puce or foreskin is seized by the thumb and forefinger and drawn 
forward, the guard or c amp is closed over the extended skin near 



SYPHILIS. 569 

them and pushed back until it meets the glans. The guard is held 
securely and the knife passing along and close to the outside, with one 
cut severs the free part of the foreskin. Upon removing the clamp 
the skin retracts behind the glans. The inner skin next to the glans 
sometimes needs additional trimming. The bleeding is slight and a 
liiit dressing completes the operation. 

Pox. — Syphilis. 

This malady has its origin in specific contamination. It is always 
described as passing through three stages, termed respectively, pri- 
mary, secondary, and tertiary. These divisions are arbitrary and 
simply save the repetition of words. The poisonous matter is re- 
ceived upon a mucous surface or some part of the skin that is 
abraded. A sore presently appears upon the point of inoculation 
and in the course of three or four weeks we have a well developed 
chancre. This is an open running sore, with a livid and highly in- 
flamed base of cup-shape and with borders hard, raised and of irregu- 
lar outline. The matter discharged is poisonous and will generate 
the disease in others. Coming upon the eye from the use of a towel 
employed by the afflicted, a very troublesome disease is generated, 
resulting not unfrequently in loss of sight. 

The secondary symptoms seldom develop before the lapse of two 
or three months. Their character is chiefly constitutional, demon- 
strating that the blood is infected. Eruptions appear upon the chest 
and abdomen, the arms and back. Suppurating sores locate about 
the corners of the mouth, the mucous surfaces of the tongue, cheeks, 
throat, the nose, vulva, etc. The glands in the neck swell and can 
be felt through the skin, particularly at the sides below and beyond 
the ears. The throat is sore, the voice husky, in time the hair falls 
out, the eyes discover internal inflammation, and the nails have sores 
at their roots. The poison appears stronger than ever and is easily 
transmitted by contact. 

The tertiary symptoms are the secondary, more aggravated and 



570 MEDICAL PRACTICE. 

intensified, working steadily toward the destruction of the body. 
The soft palate becomes ulcerated, perforated, and sometimes entirely 
eaten away. In such a case the voice has a peculiar hollow sound, 
articulation is indistinct, and foods, particularly liquids, are occa- 
sionally returned by the nose. The tongue is sore, ulcerated in spots, 
and if the case has been treated with mercury, as usually happens, 
there is inflammation of the periosteum and disease of the bones, 
particularly the long bones, distress, persistent ami loathsome diseases 
of the skin, loss of virility, abortion — if g staMon occurs — and trans- 
mission of the disease in all its vigor, if offspring is born alive. 

TREATMENT. 

Our advice to any so unfortunate as to be afflictel with this dread- 
ful malady is to c >nsult at the earliest moment an experienced and 
conscientious physician. Shun, as you would the cobra, those har- 
pies who screen their charlatanry under the secresy necessarily con- 
iv cted with the disease. Their " wonderful" remedies are all known 
to the profession, and you will get better results at the hands of the 
more skilful. 

For the chancre we employ carbolic acid, dissolving one part in 
two or four of glycerine, and apply with a compress of soft lint. 
This is continued until the sore has a healthy appearance and the 
discharge ceases. The amount of acid is then reduced. We have 
found that washing, even with the softest sponge, prevents healing. 
Hence, when the inflammation subsides, it is better to treat with a spray 
by the Atomizer (see Catarrh). Mix for this purpose one part of car- 
bolic acid with forty of water. Throw the stream upon it ten min- 
utes at a time, three or four times a day. This is excellent treatment 
for the sores upon the lips, cheeks, tongue and palate. "We have had 
good results from using the tincture of iron in a similar way. Always 
use with it the Queen's Root alterative, made in the following 



PUBERTY. 573 

moreover, are immutable and eternal — they must submit themselves 
to conditions of existence and of organization, and learn how to limit 
their desires within the spheres of their real wants. If they will do 
so, wisdom and health will bloom of themselves, and abide without 
effort; but all this is loo often forgotten when the functions of gene- 
ration are in question. This sublime gift of transmitting life — fatal 
prerogative, which man continually forfeits — at once the mainstay of 
morality, by means of family ties, and the powerful cause of depravity 
—the energetic spring of life and health — the ceaseless source of dis- 
ease and infirmity — this faculty involves almost all that man can at- 
tain of earthly happiness, or misfortune, of earthly pleasure or of 
pain ; and the tree of knowledge, of good and evil, is the symbol of it, 
as true as it is expressive. Thus, even love by its excesses hastens 
and abets the inevitable doom; for which, in the first instance, by 
the aid of passion, it had provided the victims." 

Puberty. 

Dr. Carpenter thus describes the change from childhood to youth: 
" The period of youth is distinguished by that advance in the evolu- 
tion of the generative apparatus in both sexes, and by that acquire- 
ment of its power of functional activity, which constitutes the state 
of puberty. At this epoch a considerable change takes place in the 
bodily constitution: the sexual organs undergo a much increased de- 
velopment, various parts of the surfaces, especially the chin and the 
pubes, become covered with hair; the larynx enlarges, and the voice 
becomes lower in pitch, as well as rougher and more powerful; and 
new feelings and desires are awakened in the mind. 

To the use of the sexual organs for the continuance of his race, 
Man is prompted by a powerful instinctive desire, which he shares 
with the lower animals. This instinct, like the other propensities, is 
excited by sensations; and these may either originate in the sexual 
organs themselves or may be excited by the organs of special sense." 






574 MEDICAL PRACTICE. 

Chastity. 

This is only possible upon the basis of an equal standard of 
morality for men and women. If prostitution U necessary for men 
it is honorable for women. It is neither a necessity for men nor hon- 
orable for women. Children should be taught the true function of 
sex, and the sacred obligations which pertain 1o true marriage and 
parentage. Young men should be admonished that there is not for 
them, more than for their sisters, any proper season for " sowing wild 
oats." Older men should aspire to a higher type of manhood than that 
which worships at the shrine of undiciplined desire and ignoble pas- 
sion. For women generally there should be enlarged and equal op- 
portunities, especially industrial, educational and political, that vi- 
cious men may less readily take advantage of their he^lessness and 
necessities. In this mission for the uplifting of humanity, parents, 
teachers, enlightened scientists, physicians and Christian ministers, 
one and all, should bear a part. Labor thus intelligently and con- 
scientiously bestowed cannot fail of a beneficent fruition.— (Powell.) 

Wedding Journeys. 

Reform must be effected in this custom, and it is pleasing to note 
that some of our leading physicians have already taken the initiative 
step. Confined as it is at present to their own families, but little 
time will elapse before it is copied by Iheir pa'rons and event- 
ually introduced to and adopted by the public. The effects of 
f-ucli journeys are much more disastrous to the lady than to the 
gentleman. Her labors have been arduous for many weeks previous 
to the event and both the mental and physical systems have been tax- 
ed to the uttermost. She feels the deepest interest in the ceremony 
and its surroundings, the reception and [U multitude of minutiae, 
particularly the table and menu, its tasty appearance and aesthetic 
effect. Even the fatigues of the wedding-day itself are so great as 
to call for prolonged rest and quiet. Besides the feelings are inten- 
siliod and supersei.sitive and until this tension of the nervous system 



MATERNITY. 575 

is relaxed, the exhaustion consequent upon this over-stimulation 
relieved and the injuries repaired, neither party is in a condition to 
take a long journey, which is tiresome at the best. 

Objections to Maternity Considered. 

The leading objections which women raise against child-bearing 
are: children are luxuries the poor cannot afford, or an argument to 
that effect; that women must suffer intolerably while in this state 
and incur a great risk to life at parturition, and the least weighty, that 
something important is about to transpire and the pregnant state 
would seriously interfere with the pleasures and proprieties of the 
occasion. 

In reply to these it may be said that the first is not proved by ex- 
perience. It is well known that people with limited means have fed, 
clothed and educated large families and have turned out the better 
citizens for the effort. Quite frequently it is the case that the best 
men and women were once members of large families. A married 
women who opposes having children on the ground that she cannot 
properly raise them, is a timid creature who needs words of assur- 
ance and encouragement. 

The s-econd excuse is one the physcian knows best how to answer. 
He is ready to declare that in the majority of instances women go 
through parturition without extreme suffering or imminent peril. 
And those women who have borne the most children, raise the least 
objection to bearing more. 

The third reason for not bearing children is not worthy of pro- 
found consideration. Most women can take a journey, entertain 
friends and execute most of the varied duties of life, even while in 
an advanced state of pregnancy. It is a foolish and injurious custom 
for women to withdraw from the activities of life as soon as preg- 
nancy is known to exist. The sterile woman generally has not 
enough to do and time hangs heavily upon her hands; and she sighs 
for objects on which to lavish affection and attention. The happiest 



576 MEDICAL PRACTICE. 

women, as a whole, are those who in their declining days have grown- 
up children on whom they can lean and trust. 

Fortunately for society, women are willing to undergo the discom- 
forts of child-bearing. They look upon maternity as a condition in- 
cident to the nuptial state and regard offspring as a source of hope 
and happiness. The germ of the new being gets its origin in the 
female ovary and conception takes place in her womb; and when 
the masculine and feminine elements have fruitfully blended, an em- » 
bryo or nascent being is " begotten" and it starts upon a career of 
evolution that results in adult proportions. Why should a woman 
so pervert her moral sense as to allow this, one of the chief purposes 
of her existence, to be thwarted ? Will she not learn that there is 
something elevating and refining in the latter periods of gestation ? 
Will she not appreciate that she cannot attain the height of her des- 
tiny without becoming a mother ? Wifehood and maternity are the 
crowning graces of woman. 

Incapacity Reviewed. 

Many women have their disqualifications for the marriage bed. 
Some have no control, others, from personal disrelish, a total absence 
of desire. Many, although an ungenerous world may doubt the 
truth hereof, have not the least idea of the difference of the sexes. 
There are ways of preparing females for what they will have to 
encounter at all periods of life, and no mother should fail to instruct 
her child as circumstances demand, of the expectancy of each suc- 
ceeding era of her coming existence. It is not intended thereby to 
urge that females cannot be too early initiated into the mysteries of 
matrimonial ceremonies and consequences, but there is a time and an 
age when such intelligence should be conveyed to them, and by no 
means should they be allowed to form alliance without such knowl- 
edge. The reader, we repeat, may possibly express a doubt whether 
such an event ever did occur. He may be assured that many such 
have, and do sti'l occur, and are productive of much distress. Nor 
is it intended that the physiology of reproduction should form a 



BARRENNESS. 577 

part of the preliminary education of a boarding-school girl, but no 
woman ought to become a mother without knowing something of 
the appearance of conception. It is really astounding to see the 
very great ignorance of these matters entertained by women in gene- 
ral. It may be construed into a specimen of female modesty, but it 
eventually occasions many needless fears and anxieties. Such dis- 
qualifications, however, have little to do with 



Stekility or Barrenness. 

This may be denned as an inability to produce offspring. It 
is estimated that one in every eight of the English married ladies 
are sterile. This proportion increases in the cities and diminishes in 
the country. The most beautiful women, healthy in other respects, 
are among this unfortunate class. Many of these had acute suppres- 
sion of the menses in early life or dysmenorrhcea or now suffer from 
it. In that kind of dysmenorrhcea, particularly where we have an 
inflammation of the neck of the womb and the discharge of tough 
albuminous or membranous shreds, it will continue as long as this 
continues. It is fortunate it does not happen every month; when 
cured, conception follows. Another mechanical cause is contraction 
of the canal of the neck. This can be cured by dilatation and con- 
ception follows in from twelve to eighteen months. Acid secretions 
in the vagina or neck as in leucorrhcea are causes of in fecundity, 
acting chemically in destroying spermatozoa. The treatment of the 
leucorrhcea will remove this obstacle and its consequences. "When 
the characters are very different," says Ryan, "they cannot entertain 
a state of harmony, as in a frigid or ardent individual, until age or 
habit renders them more suited to each other; thus married persons 
have passed fifteen or twenty years without offspring, notwithstand- 
ing their most anxious desires. Abraham and Sarah, and Jacob and 
Rachel are examples mentioned in sacred writings. When there is 
antipathy, disgust, hatred or passion, conception seldom happens. 
Marc is of the opinion, that the moral causes of sterility in both 
25 



578 MEDICAL PRACTICE. 

sexes are a fear to procreate, too vivid a desire to have children, an 
antipathy or incompatibility of humor between the sexes, negligence 
or apathy of the husband to the wife, the diseases and inconven- 
iences of some wives, violent passion and immorality or infidelity. 
Reserve and frigidity during the approach of the sexts is also a cause 
of sterility." The remedy in either case is apparent. As the opin- 
ions held by the childless m;iy not be well grounded, they had best 
consult some competent and practical physician before pronouncing 
decisively upon the permanency of their condition. 

Maternity. 

Let us briefly consider the requirements and see if we can meet 
them First there is a large amount of new flesh or muscle to be 
elaborated, in the enlargement and growth of the muscular fibre or 
walls of the womb itself, in the growth of the large fibrous and fleshy 
organ termed the placenta or afierbirth and also in the growth of the 
foetus or child. This calls for a large amount of what are called al- 
bumenoid substances. These are found principally in milk, eggs 
and flesh. Secondly, new bones are to be developed, which calls for 
the carbonate and phosphate of lime, particularly the latter, which 
gives to the bone its stiffness and consistency. Thirdly a new brain 
and nervous system has to be developed, being a still further demand 
for phosphorus, which is found in eggs, fish, etc. In fact the mother's 
blood should contain all the elements necessary for the perfect nu- 
trition of ail parts of the body. Food consisting in great part of 
wheat bread (refined flour), butter, tea and coffee contains but a sin- 
gle substance of any value and that in excess; but the whole grains, 
wheat, oats and barley, either as grains or in th« form of unbolted 
flour or meal, contain nitrates, phosphates ami carbonates. Add to 
thi~ vegetables, fruits, milk, eggs and beefsteak and the dietary is 
as complete as it can and should be and these can be combined so as 
to give variety enough to satisfy an epicure. 

By the use of these foods, the bowels are kept in good order, the 
strength is sustained, and cheerfulness of mind and disposition, al- 



SIGNS OF PREGNANCY. 579 

ways attendant upongood digestion and which is so necessary an 
attribute at this time, is acquired. 

Signs of Pregnanci - . 

With the suppression of the catamenial discharge following the 
connubial embrace, pregnancy may be suspected. It will be con- 
firmed by some of the many signs which attend upon gestation, no 
one of which is likely of itself to be conclusive. The breasts enlarge, 
the pinkish colored skin about the nipples turns to a brownish color 
and milk is secreted. From the stomach we have often the first signs 
and sometimes the most persistent feature. There is nausea or vom- 
iting upon rising in the morning. This may recur during the day and, 
from the upward pressure of the uterine globe in the latter months, 
may induce dyspepsia. To the sympathetic irritation of the stomach 
may be ascribed the loss of appetite, morbid appetite, heartburn and 
headache. Toothache is common. The date of a dentist's bill will 
provoke a smile -on many a mother's face. Some are annoyed by 
fainting, vertigo or palpitation. At the third month the abdomen, 
previously flatter than usual, becomes prominent and this enlarge- 
ment increases. Constipation or irritable bladder or pain in the laps 
and back, cramps of the stomach or lower extremities and itching 
of the genitals afford additional evidences of pregnancy. Between 
the fourth or fifth month quickening occurs. This is the movements 
of the foetus felt by the mother. It is a certain sign of pregnancy but 
is sometimes wanting. Like the other signs, its absence proves noth- 
ing. The movements increase in strength and frequency with age. 
During the latter part of the ninth month the globe settles percept- 
ibly downward and as a consequence vomiting ceases, breathing is 
easier, the desire to evacuate the bladder and bowels increases, walk- 
ing is more difficult, piles more painful and swelling of the veins of 
the legs more prominent. These indicate the approach of child- 
birth. 



580 MEDICAL PRACTICE. 

Diseases of Pregnancy. 

Morning sickness, as it is sometimes called, varies from a slight and 
passing feeling of nausea to a distressing malady in which vomiting 
is so persistent as to threaten and sometimes almost produce mania, 
anaemia and starvation. It comes on usually about the sixth week 
and lasts till the fourth month. When it is not excessive and does not 
derange the system, it is looked upon as a forecast of a good labor % 
and getting-up. 

TREATMENT. 

It sometimes yields to simple means and at others many things may 
be tried before hitting upon the right one. A small cup of hot cof- 
fee and a cracker or two a half hour before rising may meet the case. 
We have been in the habit of recommending 

I£. — Fluid Extract of Rhubarb, . . . one dram, 

Brandy, two drams, 

Essence of Spearmint, .... thirty drops, 
Bicarbonate of Soda, .... one dram, 

Water or Simple Syrup, .... four ounces 

Mix. 
Put a teaspoonful in half a cupful of hot water and drink while in 
bed in the morning. This may be repeated at any time that sickness 
at the stomach occurs. We have never been obliged to do so, but 
would, if necessary, apply a belladonna plaster over the womb or 
rub laudanum over the stomach. When the matrikonine (see 
page 008) is used as a uterine tonic we hear little about these and 
other distressing symptoms. It is pleasant to the taste, and we have 
always found that patients that take it in one pregnancy invariably 
send for it when they again find themselves in t.iis interesting con- 
dition. When the nausea comes on at the sight of food, give the 
dilute phosphoric acid in doses of fifteen or thirty drops in a wine- 
glass of water before either or each meal. When all means fail look 
for an ulceration of the neck of the womb and treat by topical ap- 
plications of pledgets of lint wet in carbolic acid and glycerine. 



DISEASES OF PREGNANCY. 581 

Constipation and headache are to be treated as advised in the chap- 
ters with these headings. 

Palpitation may be relieved by rest. If a remedy is wanted it 
should be the aromatic spirits of ammonia or 

1$.— Chloroform, one dram, 

Compound Spirits of Lavender, . . one ounce. 

Mix. 

Dose, a teaspoonful in a little water every three or four hours. 
Toothaclie may be remedied as advised under that heading, or by 
applying a flannel disk wetted in 
1^. — Tincture of Aconite root, 
Tincture of Arnica flowers, 

Laudanum, » equal parts. 

Mix. 

And covered with oil-silk, tin-foil, or sheet rubber to the neck just 
behind the corner of the jaw by the ear. The extraction of teeth 
during the latter months of pregnancy is dangerous, being frequently 
followed by abortion. 

Itching of the genitals may be relieved by bathing with essence of 
peppermint. This subject will be fully discussed in the essay upon 
Pruritus, to which the interested are referred. 

There are many symptoms, not amounting to a disease, and yet 
keeping up a continual irritation of the bo ly and the temper, due to 
a want of tone of the muscular system. The nervous system may be- 
come involved, if it is not already. It may be recognized by pain, sore- 
ness and uneasiness about the womb, by dull, dragging pains, rheu- 
matic ptiins, sensation of weight and fullness, weak back, restless- 
ness and sleeplessness. For all such we ha^e but one remedy, Matri- 
konine. It is a "friend in need," for it improves the health, and 
this improvement is seen in more buoyant spirits, sounder sleep 
and better appetite. 

Mania. The social degradation that attends the giving birth to an 
illegitimate child, often drives an unfortunate unmarried woman to 



582 MEDICAL PRACTICE. 

commit suicide ; therefore, when a girl or widow inquires for abor- 
tive remedies to relieve her of her troubles, she should be put under 
surveillance or placed in an asylum where she may be screened from 
the eye of a taunting world. At the proper time if she does not 
choose to take her infant and endeavor to raise it, she should be en- 
couraged to give her shame-born, yet innocent offspring to some 
childless married woman, whose heart is aching for an opportunity 
to twine its tendrils around a helpless creature; and thus one, if not 
more, would be mude happy. 

Labor. — Parturition. 

Labor is also known by such terms as delivery, childbirth, travail, 
and the French accouchement. In the description which follows, we 
confine ourselves to that class called natural labor, which requires no 
manual assistance and includes ninety or more cases in every hundred. 

At about two hundred and eighty-three days from the appearance 
of the last menstruation, the nourishment and perfection of the foetus 
is completed and the womb contracts upon its contents and expels 
"into the world" a living human being, the most helpless of the 
young of all animal creation. Its advent is announced by a slight 
flow of mucus streaked with blood and known as the show. Pains 
are felt aboiTt the lower part of the back and abdomen. False pains 
are so called because they are unattended with expulsive efforts and 
mny annoy the patient for many hours before labor regularly begins. 
True pains come and go regularly and the contraction of the womb 
can be distinctly felt by the hand placed upon the abdomen. When 
these are noticed, attention should be directed to the 

Preparation of the bed. A room should be chosen that admits of 
plenty of sunlight and has good ventilation. That part of the bed 
where the woman lays is to be protected with oil-cloth or a folded 
blanket that is not worth much. The blood and other fluids that 
pass away during delivery may be abundant enough to soil a large 
amount of valuable bedding. It is the nurse's duty to look after 
these things, but the patient should know about them and supply 



CHILDBIRTH. 583 

them if she does not arrange them. Cleanliness is enjoined here as 
well as in every .other part of the confinement. The bed-coverings 
should be light. The clothing may consist of those garments usually 
worn upon going to bed. These should be well drawn up about the 
waist to prevent soiling and a sheet folded in two used to cover and 
drape the lower part of the body. The bladder andbowels must be evac- 
uated. This is of the greatest importance. If necessary, an injection a£s 
warm water should be used to unload the rectum. It may happen 
at a later stage that it is inexpedient and hazardous to rise, and yet 
there is a desire to micturate. The folded blanket should be relied 
upon to retain the urine and no one will be the wiser for its appro- 
priation to this use. 

It is not compulsory to seek the bed as soon as the pains begin. 
For some time walking, sitting and lying down may be alternated to 
suit the inclination. When the pains are strong and frequent, the 
patient should remain in bed upon the back or side. Position is un- 
important, being more a matter of convenience, but once taken, 
should be retained. Rolling and tossing are risky because the posi- 
tion of the child's head may be changed and a natural and easy 
labor be transformed into one that is tedious, complicated, and fatal, 
perhaps. 

The physician makes a digital examination at an early period and 
for several reasons. If the neck of the womb is found in any bulk 
the time is not up and the pains are false. But if the neck is flat- 
tened to a broad thin muscle with circular opening through which, 
With every pain, something protrudes, if the bony sphere is felt fill- 
ing this outlet, if the vaginal canal is cool and lubricated by the 
show, if the external parts are soft and elastic, labor is in progress 
and one of which a speedy and happy termination may be prognos- 
ticated. The examination is made without exposure of the person 
or discomfort, and the assurance that ". all is well," willainpty repay 
for the courage exercised in overcoming any little want of confidence, 
momentary timidity, or disposition to oppose by unwise refusal. 

If, upon examination, it is discovered that the position is unnatu- 



584 MEDICAL PRACTICE. 

ral, that some other part of the body than the head presents, or a 
loop of the cord is discovered lying in the vagina, morphine in one- 
fourih grain doses, may be administered until the expulsive efforts 
cease and the patient sleeps. Two things are possible by this method: 
first, from relaxation the child may, by force of gravity or other 
cause, assume a natural position, as discovered by Prof. P. W. Allen; 
and if, as in the country, much time will likely elapse before the 
arrival of a physician, a valuable delay is secured, and little, if any, 
progress is made in the labor. 

The pains of labor may be not only mitigated but entirely over- 
come by the use of anaesthetics. We always use pure chloroform. 
If any one has any fears of, or objections to this, it may be diluted 
one-half, with ether cr alcohol. In cities the profession, as a rule, 
employ it. A single administration will convert not only the person 
in labor, but the spectators, if such there be. We believe it to be 
perfectty safe aud harmless. A lew drops are thrown upon a folded 
napkin and held about a half inch from the nose at the beginning of 
each puin. Consciousness is never completely lost, pain is sup- 
pressed, restlessness and anxiety are removed, and the uterine con- 
tractions continue with regularity and, if anything, with increased 
power. The time of labor is shortened and recovery is quickened, 
since there has been no nervous prostration and only a limited amount 
of physical effort. Every woman having knowledge of the drug 
and its salutary effect in such instances, should demand and receive 
it. " An organic affection of the heart without pulmonary complica- 
lion, rather calls for this hemi-ana?sthesia than counter-indicates it, for 
there is less danger from the agent than from the woman's sufferings. 
Chronic pulmonary lesions indicate the use of chloroform on account 
of the repose brought on by its employment, taking the place of res- 
piratory disorders brought on by painful efforts." 

The position of the child and its progress can generally be recog- 
nized by the cries of the woman, particularly if she be "noisy." 
We have attended a number of confinements in which not a sound 
or groan was uttered. Such fortitude is worthy of imitation. The 



LABOR. 585 

fcetus is suspended in watery fluid contained in a tough membrane 
or sack called the bag of waters. This bag acts as a wedge and with 
each expulsive effort dilates the mouth of the womb until it is so 
distended as to allow the escape of the head into the vagina. Up to 
this event the cries are sharp and short; after this and during the 
descent through the pelvis and soft parts, the cries resemble a long 
continued and suppressed groan. The chest walls are fixed, the 
breath held, the lips compressed, and are not relaxed until the pain 
subsides. 

The woman can now assist herself and feels inclined so to do. She 
wants a brace to her feet and something to pull. It is unnecessary 
to exhaust the strength of the nurse or physician for this purpose. 
We manage about in this way. The diagonal corners of a sheet are 
tied in a hard knot, having first twisted it into something like the 
shape of a rope. To this cloth ring the patient can hold with both 
hands. A rope is tied to it and fastened to the bed post or passed 
over the foot board and fastened to a slat. Upon the foot of the bed 
is laid a stool, ottoman or chair to brace the feet. 

It is of great advantage to the lady if the physician will make a 
roll of a napkin and with each expulsive effort press the end of the 
roll with some force against the anus. In so doing, support is given 
to the rectum, and that force which would be spent upon the bowel 
is neutralized. The peculiar advantage lies in the fact that with the 
support of the bowel, the hemorrhoidal veins are supported, and as 
a consequence, there is little, if any subsequent liability to piles. 
Few mothers are free from the affection, and a little thought at this 
time would have saved much suffering. 

During these pains the b ig of waters ruptures and discharges part 
of its wa'ery contents. Opening too early, it retards delivery; when 
the head has passed the mouth of the womb it has the opposite 
effect. It is often properly and purposely ruptured by the finger 
nail. 

When the crown of the child's head is protruding, the perineum 
(the ftesli between the vulva and anus) may, during a pain, be slipped 
2o* 



586 MEDICAL PRACTICE. 

over the child's face, when delivery occurs at once. At this time the 
expelling paint] are strong and the final ones come so closely together 
that Ihey arc termed double pains. From meddling or other causes 
the perineum when so greatly distended, may be lacerated. Rupture 
<f the perineum is not common, and when it does occur rt quires 
stitching At once while the parts are numb. The knees should be 
bound together to prevent tearing out the thread or wire. 

With the birth of the head comes a period of rest. The cord if 
about the neck is to be unwound. The next pain brings the body 
into the world, when the child, if its mouth is not filled with mucus, 
and which can be easily removed by the finger of the accoucheur, 
cries: a welcome sound to the mother who knows by this that her 
pains are about over, that her bright hopes and prospects for months 
are realized and that her babe is living. 

The child is still attached to its mother by the cord which passes 
from its navel to the placenta or afterbirth. When pulsation has 
entirely ceased the cord should be divided at a point between two 
and three inches from the child's abdomen. Contrary to common 
practice we omit tying the cord. Fully ten years ago this plan was 
advocated, and it is a pleasure to introduce the testimony of others 
in regard to the ground then taken. In one of our large city hospi- 
tals a test was made of thirty cases, in fifteen of which the ligatures 
were applied while in the remaining fifeen this procedure was 
omitted. The progress of every case was closely watched and every 
symptom noted. Of the infants whose cords were tied "four had 
severe diarrhoea without jaundice, seven had profound jaundice with 
clay-colored stools, eleven had enlargement of the liver and as for 
colic, this seemed to be a complaint shared in common by all, and 
seemingly these little ones were more troublesome, requiring more at- 
tention, appean d more fretful, in a word, they were not as good babies 
as those in which the umbilical cord was not tied." Of the untied 
cords, the seventh was divided while the cord was still pulsating 
strongly (we object to this) and the result was a loss of about three 
ounces of blood. The case however progressed favorably, and in 



DELIVERY. 587 

common with all the other cases, "the cord dropped off about the 
fifth day; no evidence of jaundice; not often annoyed with colic; 
bowels were very regular; appetites were good and sleep was sound." 
A dull pair of blunt pointed pocket scissors was used, so as to 
"hack through the cord, not at one cut, but by a sort of nibbling 
process." 

The child must then be thoroughly oiled all over with lard or anti- 
septic ointment, particularly between all folds of flesh, the toes and 
fingers, behind the ears, in the arm-pi: s and between the legs and the 
hair; wrapped in a shawl or blanket, and laid away upon its right 
side with its back to the fire, for an hour's -nap. It will then be time 
enough for the soap and water bath and the cold and tedious dress- 
ing. If these few directions, apparently so trifling, are carried out 
as we have directed, much future trouble will be avoided. The oiling 
loosens up the cheesy coating of the infant's body. Soap and water 
will not completely remove it unless sufficient pressure and rubbing 
is used to irritate the tender skin; in either case skin diseases follow. 
Oiling is the most invigorating bath we have for all persons, young 
or old. Oiling is easiest done. There is still another advantage, not 
to speak of the benefits of the sleep; if the subsequent washing with 
soap and water is imperfectly done, as is usually the case on the first 
occasion, less harmful results will follow than w T here the soap and 
water only are used. The skin of infants treated in this way are cer- 
tainly clearer, and through childhood are troubled less with pimples 
and blotches. It is placed upon the right side to facilitate changes 
going on in the heart. 

The afterbirth next needs attention. If fifteen or twenty minutes 
have elapsed and it has not been expelled, press firmly upon the uterine 
globe while the woman bears down. This will cause a pain and its 
expulsion. It may be lying in the vagina; it can then be removed 
by traction upon the cord or upon the presenting part of the pla- 
centa. This completes the* delivery. 

For the management of flooding in labor, see the treatment of hem- 
orrlmge in abortion, page 592. 



588 MEDICAL PRACTICE. 

The average duration of labor is from four to six hours. It varies, 
however, from a quarter-hour to three days. First labors are gener- 
ally most tedious, but there is less probability of trouble following, 
and recovery is less protracted and incomplete. During the progress 
of prolonged labors the patient must be occasionally refreshed with 
draughts of warm milk, hot gruel, or tea, or coffee. She must be 
rested by occasional change of position. A labor may be hastened 
by a bandage a foot wide, fastened tightly around the body and over 
the womb, but do not use medicines. We confess this is the only 
good we ever found in a bandage. Let us consider 

The Bandage. Custom is followed blindly in this matter, and, as 
in others, people seldom stop to inquire into the wli3 r s and ques- 
tion the wherefores. The majority of authors advise its use without 
specifying the reasons for it. In advising its disuse we have good 
and sufficient reasons which we will here elucidate: 

First. Regarding it as a wrap or garment, it overheats this part of 
the body (now particularly -sensitive), to the detriment of others. 
Overheating, particularly in warm weather, produces profuse perspi- 
ration, which is innocent enough of itself, but becomes a dangerous 
factor from the inclination to fan violently and cool suddenly. 

Second. It is claimed by its advocates that in consequence of 
the pressure it exerts upon the womb — now a large globe — it pro- 
duces absorption, and, as a result, hastens recovery. This is erro- 
neous, because the back and sides of the cavity in which the organ 
lies, are constructed of bone and are immovable. Pressure, there- 
fore, can only be upon the front of this globe, which has simply the 
effect of flattening it. In time, as the uterus contracts, it is evident 
that the bandage is unable in the least to press the globe. 

While the organ is thus enlarged and engorged, pressure in front is 
injurious because its effects are transmitted to the laiter portion of 
the bowel, inducing constipation. By the bandage slipping, the force 
may he applied so as to press the uterus downward, simulating and 
perhaps producing "falling of the womb." Applied in other ways 
other misplacements may follow. 



THE BANDAGE. 589 

Third. When the bandage is very tight and fastened, it gives a 
feeling of security that is hazardous. The smart woman, tightly gir- 
dled, leaves her bed long before she is physically able. The results, 
although they may not immediately follow, are disastrous, and many 
cases of misplacement and leuchorrhoea the physician traces back to 
just such times when recovery was so rapid. This support is but a 
crutch and as such should only be used when indispensable. Many 
a limb is enfeebled and cure retarded by the crutch, for if dispensed 
with, the injured limb would be exercised more, the rapidity of the 
circulation increased and with it nutrition, which is another name 
for natural healing. So in some cases the bandage being used, is 
continued in use and some support seeming to be necessary, the arti- 
ficial is permanently adopted. Those physicians who do without 
the bandage are well aware that little effort is made to leave the bed 
until recovery is complete. It may consume a week's time on such 
occasions, but the beneficial effects are felt all through after life. As 
we have plainly indicated, getting up is more prompt with the band- 
age than without it, but we hope our readers, thoughtfully weighing 
the past consequences of its use, will not be so foolish as to adopt it 
for a passing notoriety or the saving of a few day's time at this period, 
when every arrangement is made for j^our comfort, and for relieving 
you of the cares of your house and household. 

When the placenta has come away, all the soiled clothing and bed- 
ding must be removed. The thighs, hips and soft parts should be 
washed in soap and hot water and a clean napkin applied. Remove 
the rubber cloth and sheet covering, bring down the clothes from the 
waist and cover warmly. The mother is quite likely to feel chilly 
after the labor is completed, hence th-3 need of extra bed clothing. 
Darken the room, compel perfect quiet and if possible let the mother 
have a half hour's sleep. After such a refreshing slumber or after 
the infant has had its nap out and been washed and dressed, an at- 
tempt should be made to nurse it. If not successful at first do not 
prolong the effort long enough to worry and fatigue the mother or 
child. In an hour or two both may do better. In the first twenty- 



590 MEDICAL PRACTICE. 

four hours of its existence the child needs sleep more than food and 
if undisturbed, it is likely to get it. 

Contractions of the uterus continue to a limited extent after de- 
livery, causing pains resembling labor pains. These are called after- 
pains. The parent with first child escapes this annoyance usually: 
upon subsequent births they are more common. These contractions 
are necessary to expel clots and tend to restore the womb to its non- 
gravid proportions. The pain is almost completely controlled by the 
use of veratrum viride. We always use it, n< t only for this but for the 
soreness about the muscles, to prevent inflammations and control any 
tendency to milk fever or other irregularities. The prescription is, 
I?. — Tincture of Veratrum Viride . . thirty drops, 
Essence of Wintergreen, . . . twenty drops, 
Water, . . . ... ten teaspoonfuls. 

Mix. 
Dose. A teaspoonful every two, three or four hours. 

The diet should consist of good and nutritious food. Some fancy 
this is unpleasant and unpalatable, but far from it. With two to 
care for, it must be considered a lack of good sense to withhold the 
actual needs of one, but such is the customary starvation regulations 
of "toast and tea." Although the condition is similar to that of the 
amputated limb in few respects, the demands for a sustaining and 
nourishing diet are the same. If the mother wishes to retain her 
strength and at the same time develop a strong and hearty child, she 
must rely principally upon what she cats and drinks; at the same 
time she should be willing to forego to a considerable extent the de- 
sires of a depraved taste and the use of substanees which, although 
not actually harmful, are positively useless. Stimulants and condi- 
ments are useless; these include wine, beer, ale, porter, tea, coffee, 
pepper, spices, etc. In fact there is nothing to indicate a change in 
the dietary from that followed during gestation and which we noted 
in speaking of the requirements of maternity. Except in one par- 
ticular, lessening the quantity while the customary exercise is want- 
ing, there is every reason for its continuance. 



ABORTION. 591 



Abortion, Miscarriage, Premature Labor. 

These terms are synonymous. The technical differences are easily 
comprehended. Miscarriage is the general term, signifying the 
separation and expulsion of the foetus from the womb at any period 
before the full time. In this dislodgment occurs before the seventh 
month of pregnane}'', a time when the viability is supposed to be so 
well developed that life continues after birth, it is designated abor- 
lion. Premature birth is miscarriage between the seventh month 
and full term. 

The causes of abortion may be natural or accidental, and hence 
unavoidable, or they may be intentional and criminal. Diseases of 
the womb, of the ovum and of the foetus, can hardly be detected, 
and their tendency to miscarriage diverted. In the scrofulous, the 
consumptive, the syphilitic and those, afflicted with eruptive fevers, 
the attachments are insecure or readily become so. The membranes 
are sometimes rupture 1 by blows, falls, jumping, jolting, lifting or 
coughing These accidental agencies are occasionally resorted to by 
the designing, without generally meeting their expectations. There 
are other and more subtle causes of abortio 1 that need mention; 
sudden shocks, great agitation, prolonged emotions, mental and phy- 
sical exhaustion, venery and we are sorry to add, the employment 
of medicines and surgical appliances. This should be qualified to 
meet cases of necessity, where from deformity of the pelvis, from 
serious and unmanageable dropsy, from paralysis, amaurosis or like 
complications, life or some of the senses are jeopardized: a council of 
physicians could legally decide upon this method of relief. The 
medicines employed by the ignorant or prescribed or furnished by 
the professional abortionist (a viper, found not only in our large cities 
but lurking in towns and villages) are either inert or powerful irri- 
tants. The latter are dangerous, for the amount of irritation necessary f 
in the uterus to consummate the purpose, exists in every part of the 
system, increased, perhaps, in the stomach and brain, threatening if 



592 MEDICAL PRACTICE. 

not actually precipitating, gastritis, peritonitis or convulsions : surgi- 
cal means are safer but not without hazard. 

In the first and second months of gestation, miscarriage resembles 
painful menstruation. The pain is more severe and the hemorrhage 
more profuse. At all periods an attack is ushered in by hemorrhage 
more or less severe, accordirg to the cause, the time of pregnancy 
and the constitution. After tbe third month the "waters" may be 
discharged, in which case miscarriage cannot be averted. Pains 
similar to those of natural labor occur, and with greater uniformity 
as full term approaches. In cases of abortion from mechanical in- 
terference, if the neck of the womb is inflamed, the paius during 
expulsive efforts of the uterus, greatly exceed those of childbirth. 
The nervous shock may be so great as to produce rapid sinking and 
death. Hemorrhage is likely to be the prominent symptom, but fatal 
terminations may originate in the subsequent inflammation. The 
foetus may come away and the placenta or afterbirth be retained. 
This may remain for weeks without doing injury and be eventually 
expelled, or it may decay, and the body become poisoned by the 
absorption of the putrid accumulations. The hemorrhage is to be 
treated by 

I£.— Tincture of Fleabane, .... five drops, 
Tincture of Cinnamon, . . . ten drops. 

Mix. 
Given in half a cup of hot water every half hour, a hot pack to the 
lower part of the spine, the s >irit vapor bath, opium per rectum, 
and by (ihsolute rest. In addition the vagina may be filled with lint 
or old linen, which acts as a tampon or plug. See treatment of 
Menorrhagia. 

It is difficult to treat of a practice so deeply inwrought into 
social life, and yet kept so sedulously from public view. Yet there 
are things which must be said and some one must say them, taking 
the risk of being misapprehended and misrepresented. " There are 
members of the medical profession, otherwise of high standing, 
whose hands are bloody with the guilt of the crime of abortion, and 



ABORTION. 593 

abortion is committed by the wives of respectable citizens, who are 
taught to do so by their family physician." It is plain, therefore, 
that it cannot be arrested by denunciation, statutory enactment, or 
criminal prosecution, as so many seem to imagine. A Hebrew 
prophet once imprecated the women of a people: " Give them mis- 
carrying wombs and dry breasts." A woman of the nineteenth cen- 
" tury would adopt this curse as her most earnest prayer. Nor do we 
exclude the men, the fathers of our time, from the censure; men are 
seldom better than women, and, indeed, often impel women to wrong- 
doing. If men becoming husbands really loved their wives, they 
would instinctively and intuitively desire offspring by them, A true 
man always desires that the woman he loves shall be a mother; and 
a true woman, so beloved, is willing and eager to become what he 
wills. 

But our religious notions are saturated with the leaven of hypoc- 
risy; we scorn the unmarried woman whom love or weakness has 
rendered a mother, and withhold sympathy and respect from the 
married woman of frequent maternities. The fruit we are reaping 
is more bitter than the fabled apples of Sodom. Connubial love is 
dying out and homes are ceasing to exist. Selfishness underlies our 
social life and stimulates us to crime. If maternity is not revered 
as holy, it should at least be made less unhonored. Society, which 
maintains paupers and criminals, and renders benefactions to the 
impoverished and unfortunate, must do something kindly for unfor- 
tunate mothers. The rights of their children to life, and the enjoy- 
ments of life, are as good as those of the more favored. It is inhu- 
man to make such carry about with them a reproach. Let there be 
more hospitals and asylums established for pregnant women, giving 
the inmates all the privacy which their peculiar circumstances may 
demand. If they choose not to rear their own offspring, nurses and 
foster-mothers should be procured who will. Probably if those who 
are stigmatized as "fallen," could have encouragement, few would 
care to abandon their own children ; but at any rate, disgrace should 



694 MEDICAL PRACTICE. 

be warded off from mothers, and justice meted out to their guiltless 
little ones. 

Already in New York the proportion of still births to the others is 
frightful, and other cities are no better; country neighborhoods are 
do'mg their part also. Neither the Hindoo mother nor the " Heathen 
Chinee," drowning or smothering supernumerary children like pup- 
pics or kittens, is a whit behind our Christian parent. Each alike 
regards infanticide as not a crime ; yet how can we hang murderers 
of adults, while conniving at the pre-natal massacre of children? 
Herod and Kansa ought to be canonized for our veneration, with 
such a public sentiment. But let those overtaken in a fault be re- 
stored in a kindly spirit; let the ban of society be taken off the 
woman who has chanced to step beyond its provisions, and every 
encouragement given to the preservation of the lives of the unoffend- 
ing. The offence of one who loves is far less culpable than that of 
society when it places a stigma, upon her. Let her child be made 
welcome to life, and not laden with opprobrium that will make that 
life a burden. The odium cast on sexual aberration is the great cause 
of pre-natal infanticide among the unmarried, as selfishness is among 
the married. Abortion will be resorted to in order to avoid disgrace. 
Abortion is a prolific source of calamity. Cancer and other fungoid 
growths, displacement of the womb, destruction of its functions, 
metritis, hysteralgia, ovarian disease, sterility, enervation, wasting, 
and a host of ailments too numerous to recapitulate, are the sequence. 
She who commits abortion sins against her own body, as well as 
moral nature; and for it there is no remission, but a terrible expia- 
tion. Even when syphilitic and scrofulous husbands are the secret 
cause of miscarriage, the woman is still a sufferer. 

But threatening of penalties, or the infliction of physical punish- 
ment, is only a superficial method of treating the matter. There is 
no cure for abortion and its kindred mischiefs but morality, and there 
is no morality in a discipline with fear for its basis. The evil will 
be corrected when men and women become intelligent and unselfish. 
Nature has implanted the love of offspring iu every one, and with it 



CHILD-BED FEVER. 595 

the instincts which prompt to generation. Upon these we may not 
hope to improve. If God created them, he accounts them clean, and 
we may not regard them as impure or profane. In this particular is 
an important point. Meanwhile, let us in concert invoke our women 
"that their eye be not evil toward the son of their womb." Let 
every one be made welcome into existence, and as far as in us lies, 
let that existence be rendered a blessing. A house-full of well-reared 
children is more precious to persons in declining life than any accumu- 
lation of pecuniary wealth. What remembrance can be more harrow- 
ing to a woman than that of a slain embryo, of a child wounded by 
the endeavor to dislodge it from its first resting place,, or with its ex- 
istence embittered by having been born unwelcomed ? Meanwhile, 
we would caution persons never to venture upon parentage at ran- 
dom, but to be prepared in physical and mental conditions, and de- 
liberate in purpose in the matter. A child so engendered is likely to 
be under more propitious auspices. 

We appeal to teachers and educators, in whatever capacity, to im- 
press these considerations upon those with whom they have to do. 
The future of our nation and of every people, is in this issue. Mere 
moralizing, and threats of penalty, whether in our jails and prisons, 
or in the house of God, will accomplish but partial benefit. Let it 
be known, that abortion is not only an offense against God and man, 
but an act which infuses moral and physical contamination ineradi- 
cably into the person of the offender. 

Child-bed Fever. —Puerperal Fever. 

This dreaded disease combines an inflammation of the peritoneum, 
or covering of the bowels, and a blood poisoning from the absorp- 
tion of decaying matter in the womb. It is at times epidemic, and 
may be carried by the physician or nurse from one patient to another. 
It is always a good plan to enquire of either before entering the par- 
turient chamber, if they have been with patients so afflicted, within 
two or three months. If they have, it would be wise to dismiss them 



596 MEDICAL PRACTICE. 

at once and secure the services of others who have not been exposed 
to the possible contagion. This fever occurs within a week after 
confinement and is ushered in by a severe chill or by chilly sensa- 
tions. Tlie discharges stop and the milk is scanty ( r entirely wanting. 
There is pain in the abdomen, increased upon pressure. This soon 
begins to swell, eventually becoming hard and greatly distended. 
The pulse is full and rapid, skin dry, breathing hurried, tongue 
coated, thirst great, countenance pale and anxious. Restlessness, 
delirium, coma and death follow. 

TREATMENT. 

As the disease is a poison in the blood, absorbed from the uterus, 
efforts should be made to re-establish the discharge and have the cur- 
rent of matter flowing outward instead of inward, and to eliminate 
that already in the circulation. The first indication is met by inject- 
ing, by a continuous stream, a quart of water to which ten or twenty 
drops of carbolic acid have been added, into the uterus. Of course, 
it will escape as fast as introduced. The water should be quite 
warm, so as to heat and relax at the same time. This may be repeated 
in an hour. Place hot packs over the lower abdomen. To cleanse 
the blood, take 

fy—Podophyllin, two grains, 

Cream of Tartar, two drams, 

Mix thoroughly and make four powders. Give one in molasses 
every two hours until free cathaisis. Use the bed-pan or cloths to 
receive the dejections. At the same time the kidneys may be called 
into activity by 

3. —Tincture of Colchicum seeds, . . four drams, 

Spirits of Nitre, three drams, 

Acetate of Potash two drams, 

Essence of Wintergreen, . . one dram, 

Water . .... three ounces. 

Mix. 



PUERPERAL CONVULSIONS. 597 

Take a teaspoonful every two or three hours. If these means 
have been used early this terrible disease will be mastered in forty- 
eight hours. The flow re-established, the danger is past. The after- 
treatment will consist of a dose of the last recipe every six hours, and 
a teaspoonful every four hours of 

I£. — Tincture of Veratrum Viride, . . forty to sixty drops, 
Essence of Wintergreen, ■< , , twenty drops, 
"Water, . . ... . two ounces. 

Mix. 

Puerperal Convulsions. — Puerperal Eclampsia. 

When the urine contains a large amount of albumen, and when 
flashes of light appear before or during the early stages of labor or 
both, convulsions may be anticipated. The treatment will be the 
same as though they were actually present, but in a milder manner. 

TREATMENT. 

The principal indications are to stop spasmodic action and lower 
the pulse. This done, fatal effects are thwarted, and by watching 
the pulse the return of the convulsions is prohibited. Veratrum vir- 
ide should be given in small doses at first, increasing in size and fre- 
quency if the pul^e does not fall to seventy. If convulsions occur 
before this effect can be produced, chloroform should be poured, a 
teaspoonful at a time, upon a folded napkin and placed to the nose 
for inhalation, care being taken to allow a free admixture of air. 
The patient need not be placed too deeply under the anaesthetic at 
the time of the convulsions, but if the convulsions come on with in- 
creased force, it would be advisable to put the patient more deeply 
under the influence, withdrawing the anaesthetic as the spasmodic 
action ceases. But, above all, see that the chloroform is pure. As 
soon as the spasmodic action ceases sufficiently to allow the patient 
to swallow, give from ten to twenty drops of tr. veratrum viride. 
Repeat in from fifteen to thirty minutes, until all symptoms of con- 
vulsion cease, or until you get sedation from the medicine, which 
you will determine by the pulse falling to sixty, or in some cases, as 



598 MEDICAL PRACTICE. 

low as fifty pulsations a minute. If the case should be a severe one, 
and the patient not speedily recover consciousness, administer i 
brisk cathartic; also procure, if possible, a bladder filled with broken 
ice, and apply to the head. After the convulsions are broken, the 
vera: rum may be continued in from two to five drop doses every 
• three hours. 

In some cases there may be persistent vomiting from the effects of 
the veratrum ; if such should be the case you may have to employ 
brandy in small doses, one-half teaspoonful or less, by the mouth or 
by the bowel. 

If. there is coma following the convulsions, give small doses of 
tincture of belladonna until these symptoms abate. When the pa- 
tient has somewhat recovered, treat her on general principles, ac- 
cording to the indications, keeping in mind the necessity of chang- 
ing the albuminous character of the urine. 

If albumen has been discovered in the urine before labor; the con- 
vulsions may be anticipated and averted by using 

1$. — Tincture of Colchicum seeds, , . four drams, 

Spirits of Nitre, three drams, 

Acetate of Potash, .... two drams, 

Essence of Wintergreen, . . . one dram, 

Water, three ounces. 

Mix. 
Take a teaspoonful every three hours. 

Puerperal Mania. 

Insanity is likely to follow childbirth in those hereditarily predis- 
posed and in the hysterical. There is in such an extreme susceptibil- 
ity to excitement, which is increased during pregnancy. We find 
deranged digestion, frequent headaches, restlessness, sleeplessness 
and sometimes suppression of the discharge. Mania m?iy appear 
at any time before birth or immediately after. Like insanity from 
any cause, it may develop a mild type like melancholia, or madness; 
may exist for a few hours or for life. 



SUPPRESSION OF MENSES. 599 

TREATMENT. 

If the discharge is stopped it must be restored as above described. - 

To relieve the distress (congestion) in the head give teaspoonf ul doses 

of calcined magnesia every hour until the bowels move freely. 

Follow with 

1$. — Tincture of Gels eminum, . . . . two drams, 

Tincture of Black Cohosh, . . . one dram, 

Simple Syrup, ...... one ounce. 

Mix. 

A teaspoonful every four hours should be given and continued for 

as long a time as the mania remains. 

Amenorrhcea. 

Suppression of the menstrual flow may be due at times to natural 
causes. These include their cessation at the critical period in advanced 
life and the inception of ge-tation. As a disease it has acute causes 
such as suddenly taking cold, emotional feelings, distressing news, 
sudden and prolonged fear or fright, and the like. As a chronic dis- 
ease its origin is usually to be found in those influences which pro- 
duce great depression ot the vital forces. Local inflammation or 
bloodlessness, sedentary habits of school girls, the conditions of the 
system in consumption and in chlorosis, are all agents in its develop- 
ment. Hemorrhages, whether from the bowels, lungs or stomach, 
may be classed as causes, and are not unfrequently a vicarious opera- 
tion of the menstrual function. In perforate hymen may assimi- 
late it. 

treatment. 

To bring about regularity requires removal of the cause, whatever 
it may be. Consumption, chlorosis, local inflammation and oppres- 
sion of the vital forces, demand remedies peculiar to themselves, and 
when they are benefited or remedied the menstrual function will be 
resumed without the adoption of means specially directed to that 
end. To relieve the headache, flushed face, hot skin, generally 
caused by cold, or strong emotions, put the patient to bed and .apply 



600 MEDICAL PRACTICE. 

the hot pack to the abdomen. Hot foot-baths should be given wJiile in 
bed. If anj- remedy is required, some diaphoretic, as hot tea or cayenne 
pepper and hot milk, may be taken. If preferred, administer the 
following powder: 

I£. — Morphia, one grain, 

Powdered Camphor, .... twenty grains, 

Bicarbonate of Potash, . . . twenty grains, \. 

Licorice, . .... twenty grains. 

Mix, and make ten powders, and give one every three or four 
hours. This does not nauseate, promotes perspiration, causes free 
circulation, and quiets nervous tension. If the patient is full-blooded, 
with flushed face and strong, full pulse, administer some laxative. 
Aloes seems particularly indicated in this disease, as it exerts its 
greater force upon the lower abdominal viscera. A pill composed of 
1$. — Aloes, ... . one grain, 

Extract of Nux Vomica, . . one-half grain, 
Licorice, . ... one grain, 

May be given. The diet should be limited and plenty of outdoor 
exercise enjoined. In anaemia, the food should be rich and plentiful 
and every hj r gienic means employed that will tone up the system. 
After a mild laxative, such as the rhubarb cordial, in a majority of 
cases iron is indicated. "We prefer to combine it as follows: 

1£. — Sulph. Magnesia, . . two drams, 

Sulph. Iron, . . . eight grains, 

Sulph. Quinia, . . . twelve grains, 

Dilute Sulphuric Acid, . one and one-half drams, 

Fluid Extract Ginger, . . two drams, 

Simple Syrup, . . . one ounce, 

Water, . . . eight ounces. 

Mix. 

Take two tablespoonfuls night and morning. Or, when iron dis- 
agrees, 



PAINFUL MENSTRUATION. 601 

1$. — Tincture of Guaiac, .... one ounce, 
Tincture of Ergot, .... one ounce, 

Simple Syrup, . . . . four ounces. 

Mix. 
Take a teaspoonf ul three t : mes a day after meals. 
We have relieved many cases with Matrikonine. When possessed 
of an office battery, the judicious application of electricity will be 
found effectual, supplement d, if desired, with the aloes laxative. 
It should be used with regularity twice a day for the three days pre- 
vious to the time of its expected appearance. 

Painful. Menstruation. — Dymienorrh<m. 

Not more than five per cent, menstruate without some pain, vary- 
ing from slight disturbance to intense pain, equaling if not exceeding 
that of labor. The term is a geDeral one and may be divided into 
ovarian and uterine, and subdivided into congestive, inflammatory, 
membranous, neuralgic, that from prolapsus or chronic metritis 
and obstruction caused by some malposition of the womb which 
bends and partly occludes the discharging canal. 

In ovarian dysmenorrhoea there is constant and severe pain in the 
region of the ovaries at either side of the lower abdomen, much 
headache, and frequently vomiiing. The pain appears for one or 
two days before the discharge, and for one or two days afterward. 
In rare cases convulsions are met with. In all the varieties of this 
affection there is, preceding the attack, a feeling of languor and 
weariness, pain in the back, a feeling of weight in the lower part of 
the abdomen, followed during the occasion with periodic pains in- 
crease in intensity of the symptoms, and sometimes fever, los3 of 
appetite, headache and vomiting. 

TREATMENT. 

When there is prolapsus or misplacement of the uterus, the correct 
adjustment must precede all curative efforts tending to relieve the 
painful menstruation. In ovarian dysmenorrhoea, give 



602 MEDICAL PRACTICE. 

$. — Muriate of Ammonia, . . . two drams, 
Tincture Aconite leaves, . . . two drams, 
Water, or Simple Syrup, . . . eight ounces. 

Mix. 

Take a teaspoonful every three hours from beginning of pain to 
end of period. In addition to rest in bed, apply hot packs to the 
lower part of the abdomen and give opium at night. This treatment 
applies in the neuralgic type. 

In all cases of functional dysmenorrhoea, we rely upon the vibur- 
num compound with or without the addition of gelseminum three 
to five drops to a dose. 

In metritis, or inflammation of the womb, which is chronic, and is 
accompanied with enlargement of this organ, there is tenderness and 
pain on pressure over the womb and usually some discharge, more or 
less fever and pain running down the thighs or groins. This dys- 
menorrhoea can be relieved by the treatment Jast mentioned. During 
the intervals, injeciions of hot water should be used each day, as 
hot as can be borne. Some will tolerate as high a temperature as 
98° to 104°. A family syringe that will throw a constant and stead- 
fast stream should be employed, and the operation continued for 
fifteen minutes at each application. Every female, single or mar- 
ried, should possess such an instrument on the ground of cleanliness, 
to thoroughly wash out the vagina with luke-warm water after each 
menstruation. 

There are a few cases of dysmenorrhoea caused by the contraction 
of the cnnal of the neck. This can only be riscovercd and treated 
by the physician or surgeon. The treatment consists of dilating by 
the sponge tent, or, better still, to secure a permanent and perfect 
cure, by incision. After opening, introduce a tampon or plug of 
clean oakum previously soaked in carbolic acid and water, one 
part to twenty. After a few hours, if any oozing is noticed, dip the 
tampon in a weak solution of persulphate of iron and reapply. 



EXCESSIVE MENSTRUATION. 603 

Menorrhagia 

Signifies profuse men-truation, but may apply to unnatural and 
unusual frequency, quantity or continuance. In either instance the 
recurrence is due to organic disease of the uterus, to general debility 
from excitement or excessive labor, or to a constitutional condition 
tending to hemorrhage. 

TREATMENT. 

In most cases, uterine and constitutional tonics are indicated. We 
prefer for such a purpose, 

1$. — Tincture of Guaiac, . . . one ounce, 

Fluid Ext. of Ergot, .... one ounce, 
Fluid Ext. of Hamamelis, . . . one ounce, 

Simple Syrup, four ounces. 

Mix. 
During the hemorrhage take cinnamon and hemlock barks, and 
witch hazel leaves, equal parts of each and make a strong tea. Give 
a tablespoonful every half hour or hour. Or 

J$. — Tincture of Fleabane, .... one dram, 
Tincture of Cinnamon, .... ten drops, 

Glycerine, one ounce. 

Mix and give ten drops every two or three hours. Complete rest 
in bed must be enjoined. Cold packs may be applied to the abdo- 
men, and a bag of hot salt to the lower spine. If abortion is sus- 
pected, a physician should be called. 

Vulvitis. 

This is an inflammation of the lips at the entrance of the vaginal 
canal, seldom occurring as a disease of itself. It is an accompaniment 
of other female complaints, chief among which are acrid leucorrhcea, 
falling of the womb and inflamed vagina. The prominent symp- 
toms are pain, heat, swelling, sometimes to such an extent as to close 
the canal, and inability to sit, stand, walk, or pass water without dif- 



604 MEDICAL PRACTICE. 

ficulty. Itching of the parts and surrounding surface is often dis- 
tressing. 

TREATMENT. 

Make a poultice of hops and lobelia, equal parts, and apply con- 
tinuously, renewing as often as it loses its best, until the swelling 
subsides. For the itchiug see treatment of Pruritus Vulvae. 

Vaginitis. 

By this term is signified an inflammation of the lining mem- 
brane of the genital organs of the female. It may be caused by a 
relaxed condition of the membrane and of contiguous muscles, by 
misplacement of the womb, by specific inoculation and other causes. 
It is so invariably attended with the discharge of large quantities of 
while vitiated mucus, and the treatment varies so little from that of 
Leucoj-rhaxt, that the reader is referred to that subject for further 
particulars. In addition to the means then recommended, we call 
attention to the fact that glycerine and water used with the Irrigator 
although followed by an increased discharge of water, speedily allays 
the heat. 

Womb Diseases — Uterine Complaints. 

Foremost among these is an inflammation of the womb, metritis. 
This is quite common in the chronic form when it appears as a perma- 
nently congested and enlarged state of this organ. When appearing 
suddenly, as it does after delivery or abortion, there is heat, pain, 
swelling, tenderness upon pressure and a high fever with vomiting 
and headache. In time the peritoneum becomes involved, the bowels 
bloat, the milk is defective or wanting, the discharges lessened or 
stopped, and the urine dark and scalding when passed. The treatment 
of this condition consists of the use of warm water injections, a a hot 
as can be borne, into the vagina, and internally veratrum in three-drop 
dose-* every one, two or three hours. In the chronic form there is 
the permanent enlargement to which we have alluded Even this is 
mbject to v riation. A hard day's work, long standing on the feet, 



DISPLACEMENTS. 605 

or lifting heavy weights, all tend to further congest the organ ; some- 
times in a few hours its enlargement is quite perceptible. A night's 
rest tends to restore its dimensions, but not to the normal propor- 
tions. With this distention other organs suffer by pressure, as the 
bladder, bowels and stomach. These become irritable and some- 
times inflame: more frequentlythere is disturbance of their functions. 
But chronic inflammation does not always involve the body of the 
womb, as just described. It may attach to the lining membrane and 
produce catarrh, a uterine leuchorrhcea with a thick ropy discharge. 
I The body may be quite free from disease and yet the neck or 
lower portion be painful, hot, and swollen. This is the case in 
dropsy and ulceration of the neck.. The condition can he best ascer- 
tained by local examination, but may be suspected if there is pain 




VAGINAL SPECULtTM. 

in the back and on the top of the head, with constipation generally, 
etc. The treatment we will notice when we come to consider female 
weaknesses, a more popular but less accurate term applied to these 
affections. We wish first to describe uterine 
Displacements. 

The womb occupies the pelvic outlet and is firmly held in place 
by strong, fibrous, or muscular bands. In general good health these 
are all sufficient. It is evident that continued pressure, and all other 
agencies that weaken or relax muscular fibre, will lessen this hold 
and result, necessarily, in displacement. The whole organ may be 
thrown forward, and resting upon the bladder, irritate this viscus, 
causing chronic cystitis and other disorders. This is called anti-ver* 



606 MEDICAL PRACTICE. 

sion. It is more frequent than retroversion, because, in its natural 
position, the body of the womb is slightly inclined forward. Retro- 
version is a similar misplacement, but in an opposite direction. The 
weight, rests upon the rectum, producing persistent constipation, if 
nothing worse. From the inflammation attending uterine version, 
adhesions are not unfrrquent, and hence replacement is rendered diffi- 
cult or impossible. Uterine flexion is a limited or incomplete version. 
Th • neck remains at, or nearly in, its proper place, and the body, the 
upper and heavier portion of this pear-shaped organ, inclines for- 
ward, called anti-flexion, or backward called retro-flexion. The symp- 
toms are less severe than in the case of version, but play an impor- 
tant part in engendering dysmenorrhea or painful menstruation. 
Bending a straw at right angles illustrates the condition of the uterine 
canal, the constriction at the bending point showing, in a rude way, 
the obstacle 1o be encountered in ihe passage of the menstrual fluid. 
To rectify either version or flexion requires the physician's aid. In 
those in whom the displacement is recent, or but slight, a cure may 
be effected by following, as far as applicable, the treatment given 
below. An emphatic protest is made against following the advice 
sometimes given to patients. It is that in antiflexion they should 
hold their urine as long as possible, so that the distended bladder may 
raise up the depending body of the womb, and for the same purpose 
in retroflexion, that the feces should be retained. Such management 
does not the least good, but, on the contrary, harm and only harm. 
Inversion is a third form of version. Not only does the uterus come 
down, but literally turns inside out. The rude abstraction of the 
afterbirth, traction upon the cord in rapid labor, and weighty tumors 
produce it. Fortunately it is very rare. 

Falling of the Womb. — Prolopsus Uteri. 

This displacement is neither to one side or the other, but directly 
downward into the vaginal canal. It may even go so far as to pro- 
trude "into the world." All the ligaments and muscles are relaxed 



FALLEN WOMB. 



607 



and enfeebled as well as the surrounding tissues. Congestion and 
leucorrhoea weaken tbe vaginal walls. The bladder is dragged out of 
pi ice and inflamed, and the urine dark-colored and burning. The 
rectum is submitted to pressure and persistent constipation and piles 
attend. The back aches continually while upon the feet, and walk- 
ing is slow, measured and difficult. The stomach soon becomes in- 
volved and we have the symptoms of dyspepsia. 

TREATMENT. 

Corsets and all constricting bands about the waist which bear the 
weight of the skirts must be removed and the clothes so made as to 
receive support from the shoulders. Flannels, light or heavy, must 
afford an even warmth of surface the year round. To still further en- 
courage healthy circulation of blood, the whole body should be daily 
bathed, rubbed and submitted to gentle blows by the palm of the 
hand. When practicable, these offices may be rendered by an assis- 
tant. Knead the abdomen thoroughly and oil with the antiseptic 
ointment. Keep the bladder empty and the bowels solvent and reg- 
ular in either instance without straining (see Constipation). Avoid 
lifting as much as possible. All treatment will be useless unless the leu- 
corrhoea is cured (see Leucorrhoea). Treatment for this should there- 
fore begin with the other means advised. At the outset it will be 
best to lay in bed for some time, if possible a week. The best form 
of exercise is walking. The distance should be short at first but daily 
increased, if but a little. 
The walking and strok- 
ing give tone to the whole 
system and to the pelvic 
contents in particular. 
Upon first attempting to 
walk after the rest, a 
perineal support may be 
necessary. This consists 
of a stout band of web- 
bing some two inches in perineal supporter. 




608 MEDICAL PRACTICE. 

width and possessing only sufficient elastricity to give an inch or two. 
A belt of this passes around the hips (not the waist) and is buckled or 
buttoned in front. On the back are sewed two buttons about six 
inches apart. From these pass bands of stout cotton down to a pad 
placed against the perineum. (The perineum is the part of the body 
between the anus and vulva). Two similar bands, but narrower, se- 
cured to the front of the pad pass forward and are fastened by buttons 
to the belt in front. First fasten to the belt the buckles and buttons. 
Then make the pad and sew on the four tapes. The places for work- 
ing the button holes are then easily found. Complete rest is neces- 
sary during menstruation. Upon retiring, the womb should be ele- 
vated as far as possible, with the finger. For int< rnal treatment we 
employ a preparation to which, we have given the name of Matriko- 
nfne. This is so compounded as to meet every indication It relieves 
irritation of the bladder, excit< s healthy action of the bowels, tones 
up the mucous surfaces, strengthens museular tissue, contracts the 
fibres of the womb, thereby diminishing the engorgement or enlarged 
condition and diminishing the weight of this organ, and its tonic ef- 
fect is noticed in improved appetite and digestion. It is composed of 
$.— Beth root, 

Dogwood bark, 

Ergot of Rye, 

East India Kino, 

Tulip Tree bark, 

Holland gin or the 

Wine of the native grape and 

Crushed sugar. 

If it were not for M taking the wind out of our sails" we would be 
more explicit. As paradoxical as it may seem we are a disbeliever 
in patent medicines and only reserve the method of manufacture for 
personal security. That it possesses merit a multitude of those once 
afflicted bear witness. Still it might fail if not prepared from pure 
and carefully selected drugs. The price is out of proportion to its 
value and can only be held at the low figure by manufacturing in 



WEAKNESSES. 609 

large quantities. Unlike most nostrums in the market, we do not re- 
commend it as a cure-all, although it has been used successfully in the 
treatment of morning sickness, flooding, suppressed menstruation, 
dysmenorrhea and leucorrhcea, but we do believe it to be unrivalled as 
a uterine tonic to reduce chronic enlargement and to restore relaxed 
muscles to their normal strength. To show good faith we will send 
a limited number of bottles free to those who from impecuniosity 
feel unable to bear the expense, or will send a sample to every one 
buying a copy of this book of the author, providing it is requested 
at the time of purchase. 

Tumors of the womb occupy different positions. They may locate 
in the substance, or attach to the lining membrane, or occupy the 
cavity of the organ. In either case the long continued use of the 
Matrikonine, by keeping up a rigid contraction of the muscular fibres, 
not only prevents their further growth but has in many instances 
promoted their absorption ; its advantages over the use of the sur- 
geon's knife is apparent, not to speak of the fortunate escape from the 
dreaded operation. 

FEMALE WEAKNESS. 

Under this general heading we propose in a brief manner to dis- 
cuss the conditions, causes and indications for treatment for the mal- 
adies we have just described. 

The afflicted complain of pain at the -top or back of the head, un- 
easiness and dull pain in the small of the back, and a heavy dragging 
feeling through the lower abdomen. The head is hot and the feet 
cold. The appetite is poor, digestion imperfect, nutrition impaired 
and bowels constipated. The urine is frequently passed and some- 
times scalds while escaping. Leucorrhcea attends in most instances. 
The blood is poor and the muscular system deficient, flabby, and re- 
laxed. They are flat-chested or the breasts are dependent, the abdo- 
men protrudes, the shoulders droop, with a marked depression at the 
pit of the stomach. The face is pale, the eyes hollow, and dark rings 
about them. The nervous system suffers; there is languor, restless- 
26* 




ouTLnns or female form with weak muscles and stxptome of mno 

DISEASE. 




OUTLINE OF HEALTHFUL FEMALE FORM. 



612 MEDICAL PRACTICE. 

ness, prostration, and perhaps palpitation. Of course, we do not 
meet all of these symptoms in any given ease, but the most of them 
usually appear. 

The causes arc sedentary habits, colds taken at the menstrual pe- 
riod, masturbation, excessive coitus, abortions, too rapid child-bear- 
ing, prolonged nursing, excessive household labors coupled with the 
care of children, and tight lacing. Corsets hinder wholesome exer- 
cise and prevent the free play of the int rnal organs. The muscles 
waste away and become thin and f< eble and are unable to do their 
proper work. They permit the bowels to gravitate out of their nor- 
mal position and these become pendulous. The mechanical pressure 
created by the lacing presses the contents of the abdomen toward the 
pelvis, and the pelvic contents are crowded down below their natural 
position. This is the cause of the "pot-bellied" appearance of 
many fashionable women. For whatever sphere such women may 
be fit, they are entirely unsuitable for the great functions of woman- 
hood: maternity. 

TREATMENT. 

All habits and influences which tend to debilitate must be dis- 
missed. Instead, hygienic means must be substituted. These consist 
of rest, in more senses of the word than one, good food, sunlight, 
air and dress. Dispensing with corsets, the rubbing and stroking 
may, and often does, precipitate a crisis. But this is the shadowed 
vale through which many must pass to reach the health-summits be- 
yond; once passed, the health and strength rapidly improve. In dis- 
placements and ulceration it is of no use to rectify position, etc., 
unless you tone up the system between the menstrual periods, and 
during the flow, support the nervous system. Matrikonine, or other 
uterine tonics, wifl answer this purpose. 

In writing upon the cure of metritis, Dr. Storer remarks: "If the 
woman is left to the unbridled caresses of even a considerate hus- 
band, or is allowed to indulge in any of the conjugal indecencies of 
the present day, preventing impregnation" by various means, " or, that 
worst measure of all, incomplete intercourse, the practitioner's hands 



PESSARIES. 



613 



are tied. He cannot expect to effect a cure." This hint to the wise 
will be sufficient. 

Physicians frequently and carelessly perhaps advise childbearing 
as a cure for "female weakness." This is to be regretted on many 
accounts; chiefly because to have sound, healthy children, the 
mother must be sound and healthy. In the later months of preg- 
nancy the womb rests upon the pelvic bones, but this support is 
only temporary, for after delivery the prolapse is generally aggre- 
vated. It consumes from four to six weeks before the womb is 
degenerated and absorbed sufficiently to resume its previous or 
healthy proportions, and the mother is unwilling to be confined to 
the bed for such a long time. If she will do this and nun»e her baby, 
inasmuch as irritation of the breasts promotes absorption of the su- 
perfluous tissue in the uterus, benefit may follow such advice. 

Pessaries or uterine supports do nothing, or next to nothing, to- 
.ward removing the cause of the difficulties ihey are expected to 
meet, even when the results of their use are most satisfactory and 
complete. Any mode of treatment which shall succeed in restoring 
the natural supports renders these mechanical substitutes unnecessary. 
The pessary is commonly compared by its advocates to the crutch, 




soft-rubber fessart, inflated. 



SCANZONl'S SPRING PESSART. 



but is wanting in the principal points of the analogy. The limbs 
are taxed with supporting the body. The uterus does not support 



614 MEDICAL PRACTICE. 

but is itself supported. Hence the mechanical appliance is not a 
substitute of function and the disuse of the supporting muscles thus 
brought about often has the effect noticed with other muscles, weak- 
ening and withering. It is reasonable, and facts confirm the posi- 
tion taken, that the muscles must be well nourished by improved 
circulation of blood and their contractility and activity increased. 




BABCOCK'S PE83AHY APPLIED. 

Whether yours may be one of those rare and exceptional cases in 
which a pessary is necessary or not, it is your privilege- to use the 
makeshift if you wish; the acknowledged freedom of the individual 
warrants such a course. As a medical adviser it is our duty to 
inform you correctly, and this duty we have performed faithfully and 
conscientiously. 



VAGINAL CATARRH. 615 

Whites. — Leuchorrhcea. 

This is one of the most common of female complaints. To a cer- 
tain extent it is but an index or symptom of other disorders. A good 
definition is catarrh of the vagina, or uterus, or both. The symptoms 
of its presence are, the appearance of mucus in more than ordinary 
quantities at the vulva, varying in quantity and in quality. The 
consistency may be watery and colorless, or thick; white, yellow, or 
green ; pasty or stringy. A sense of weight with irritation of the 
bladder or rectum is felt, with or without pain in the lower part of 
the abdomen. 

Leuchorrhcea is sometimes met with in children. Exclusive of 
any hereditary taint, it may be caused by the smegma or cheesy sub- 
stance covering the infant at birth, and which is imperfectly or only 
partially removed during the first washings. Later it may arise 
from the confinement of urine which has become decomposed. Not 
unfrequently, in childhood, it is developed by the presence of for- 
eign bodies which have been introduced by the sufferer. 

There is such a wide range in the character of the discharge that 
description is difficult. It differs in the same individual at different 
times, from the seat of the catarrh, whether uterine or vaginal, and 
from the exciting cause. In most cases the lining membrane of 
these organs is inflamed or congested and thickened. A partly pro- 
lapsed womb, irregular menstruation, the pressure of morbid growths, 
excessive sexual intercourse or childbearing ; all cause, prolong and 
intensify leuchorrhcea. Like all catarrhs it is usually associated with 
vitiated blood, nervous prostration and general debility. We have 
seen many cases result directly from a cold; cough, from the violent 
exercise of the diaphragm, may congest these parts and produce an 
acute attack. Specific diseases develop virulent leuchorrhcea. 

TREATMENT. 

It is obvious from the varied nature of the malady and the diver- 
sified causes, that only a line of treatment, general in its application, 
can be attempted. In the first place it is necessary to correct dis- 



616 MEDICAL PRACTICE. 

placement, remove congestion and morbid growths, and regulate 
menstruation, if any of these affections are present. 

When the disease is vaginal, its cure is simple and rapid. Medi- 
cated injections, combining an antiseptic and a remedy healing to 
mucous membranes, is all that is required. Take of the 

3.— Sulphate of Zinc, . . . .one dram, 

Fluid Extract of Golden Seal, . . one ounce, 

Glycerine, one ounce. 

Mix. 

Put two drams in one pint of warm water and use the full quan- 
tity twice a day. Or the following may be used : 

i^.— Carbolic Acid, pure, .... thirty drops, 
Tincture of Opium, .... four drams, 

Glycerine, three ounces, ' 

Water, three ounces. 

Mix with one, two or three parts of lukewarm water, bulk for 
bulk. The amouut added depends upon whether the lining of the mu- 
cous membrane is in a more Or less raw or denuded condition. The 
glycerine at first increases the watery discharge. 

All injections used in treating leucorrhcea should be administered 
with a syringe, throwing a continuous stream. Those wishing to 
economize should have the liquid passing from the body fall so as to 
feed the syringe, thus permitting so small a quantity as a pint to 
answer as well as many times the same. To be effective, the cleans- 
ing must be thorough, never failing to reach every point of the dis- 
eased surface. 

An instrument has been invented by Dr. Griswold which we have 
employed with remarkable results and which we consider indispen- 
sable to the rational and rapid cure of leucorrhcea. It meets a want 
long felt by the profession in treating this affection, ulceration of the 
neck of the womb, passive hemorrhages, and ulcers of any kind 
upon the vaginal walls. As an attachment to the ordinary family 
syringe, to be employed after menstruation, it has no rival in point 



LEUCORRHCEA. 



617 



Pig. 1. 




Fig. 2. 
common syringes now in use. 
are necessary. 



of cleanliness. Both the profession and 
public appreciate it as soon as exhibited, 
and if we could spare the space, almost 
numberless testimonials in its favor might 
be introduced. 

Griswold's Irrigator consists of a 
cage-like structure made of non-corrosive 
metal (see C, Fig. 1) with longitudinal ribs, 
c, c, c, c, converging at one end to a com- 
mon centre. The object of the end is 
facility in introduction, and of the ribs to 
put the mucous membrane of the vaginal 
canal upon the stretch, thus exposing the 
whole surface by smoothing and extending 
any and all folds of tissue. These ribs, c, 
c, c, c, are made of cylindric wire of suita- 
ble diameter and are attached to braces, 
one of which is represented in Fig. 2. 
These braces have a circular opening 
through which the nozzle of the syringe 
A, passes. In Fig. 1 it is represented in 
place. There are also notches in the brace ; 
see /, /, Fig. 2, which permits the free 
outflow of liquids that have been thrown 
through the nozzle and of all mucus and 
other impurities. The nozzle A is perfo- 
rated along its inner half with minute 
holes, from which the liquid passes 
directly to the membrane. The outer end 
is supplied with a screw-thread b) r which it 
can be attached to a tube and compressi- 
ble bulb, see B, Fig. 3, or to most of the 
For its use no explicit instructions 



618 MEDICAL PRACTICE. 




Fig. 3. 

In reviewing the difficulties experienced in our practice with other 
syringes, we find them entirely overcome in employing the Irrigator. 
The objection to most syringes is that independently of the remedy 
employed, the liquid touches but comparatively little of the mem- 
brane and a gulley or valley is formed and the fluid returns by this 
channel. Neither the piston nor fountain syriugi s throw the medica- 
tion into the folds of the vagina, the very place where the disease is 
most firmly seated. Nor does the pipe distend the canal sufficient- 
ly. Iu those instruments in which it does, provision for the return 
flow is deficient. The Irrigator cleanses thoroughly; other methods 
do not do this much. Some have square ends and hence are difficult 
to put in place, others pinch or otherwise do injury. There are none 
of these objections to the instrument recommended. The sulphate 
of zinc is the remedy generally employed, but this does harm be- 
cause it coagulates the albumen which exists to so large an extent in 
leueorrhreal discharges. With the Irrigator, if such concretions 
form, they are promptly expelled. In some females the orifice of 
the vagina is small and so constructed that part of the fluid injected 
is retained, but with the Irrigator the orifice is opened to exactly the 
same extent as the internal mucous membrane, making a continuous 
pipe of the same dinmeter, with free inlet and outlet. 

Some physicians object to local treatment, claiming that it will not 
overcome a disease which is partly constitutional. This may be 



UTERINE CATARRH. 619 

based entirely upon theoretical grounds, but to such we would reply 
that part of the remedy is absorbed. This is all that can be expect- 
of it if taken into the stomach; in both cases the general effect de- 
pends upon absorption. Even if there be an uncertainty about that, 
of this fact we have ample proof — the Irrigator cures. 

The fluid should always be warm and in vaginitis, hot. Cold 
water, used by the common syringes, sometimes causes uterine colic. 

Uterine leucborrhcea is much more difficult to tn at, and we doubt 
if any one could succeed in their attempts at self -cure. This species, 
in most cases, develops a stringy, thickigh or membranous discharge. 
The best local treatment consists in swabbing out the uterine cavity 
with cotton-wool previously soaked in a strong solution of carbolic 
acid and, to facilitate the operation, wound around a probe. This 
is repeated every three or four days. Another plan is to make sup- 
positories of 

I£ — Extract of Belladonna one part, 

Nitrate of Silver crystals, .... two parts, 

Simple Cerate, two parts. 

Mix. 
Introduce a tube evr ry eight or nine days, and in the course of two 
or three months the discharge and its attendant dysmenorrhcea will 
cease. 

In treating this disease it is necessary to adopt every means that 
will benefit the general health, such as attention to diet, clean- 
liness, exercise, and particularly, regular evacuations of the bowels 
and the bladder. In order that a cure may be permanent, tonics both 
constitutional and uterine should be continued for some time after 
recovery is supposed to be complete. For this purpose we recom- 
mend the use of Matrikonine or some similar preparation. 

Milk leg, White Swelling.— PliUgmntm Dolens. 

The exact cause of this disorder is not known, but we agree in 
opinion with those who believe it to be due to an inflammation of 



620 MEDICAL PRACTICE. 

the veins (phlebitis) of the leg. From pressure above, the blood is 
unable to flow, ti e vein enlarg s, becomes weak, and a dropsical ef- 
fusion takes place. From one 10 three weeks after delivery there is 
a chill, and one of the legs (sel om both) becomes tender, painful, 
and begins to swell. The larger veins are distended and tortuous 
and feel bard an 1 knotted. Soon the limb swells, becomes Mhite, 
tense and shining, and m iy be hot, but is sometimes cold. After a 
few days the hardness diminishes and the limb remains puffy and 
dropsical for an indefinite period. Sores and abscesses may follow. 

TTCEATMENT. 

As soon as pain is noticed in the leg give a mild and ur.irri- 
tating cathartic such as calcined magnesia in teaspoonful doses in 
water or milk until the motions are free and watery. This a good 
anti-dropsical treatment also, and in a measure anticipates the result 
of the disease. If feverish, 

I£. — Tincture of Veratrum Viride, . . forty drops, 

Water, twelve spoonfuls, 

Mix. 
Take a spoonful every four hours. Two hours after each dose 
take a teaspoonful of 

1^. — Tincture of Colchicum seeds, . . . four drams, 

Spirits of Nitre, three drams, 

Acetate of Pota«h, two drams, 

Essence of Wintergreen, .... one dram, 

Water, three ounces 

Mix 
If there is no fever, give this every three hours. To subdue the 
pain and inflammation in the leg, bathe gently and frequently with 
this lotion: 

fy— Tincture of Aconite root, 
Tincture of Arnica flowers, 

Laudanum, in equal parts 

Mix. 



INFLAMED BREAST. 621 

Before attempting to do housework or walk about, the whole leg, 
from the toes to the body, should be carefully and snugly bandaged 
with a long strip of flannel carefully overlapping its edge each time 
it encircles the leg. It' it becomes loose it should be re-applied. 
When the inflammation has departed a compress may be used of 
flannel wet in a solution of sulphate of iron, one ounce, and hot 
water, one pint, placed over the ve.n as hot as can be borne. 



DISEASES OF THE BREASTS. 



Mothers often suffer much from the heat, pain and swelling of the 
breasts while nursing, and soreness of the nipples. Is otun frequently 
the glands " cake and gather," terminating in abscesses and fistulae, 
a deplorable condition, undermining the health of the mother by 
the pain, fever and loss of sleep. The child suffers also from the 
deeri oration in the quality of the milk and must be weaned peremp- 
torily, and in the first months of its life, to prolong its existence. So 
unfortunate a disaster and very much of the trouble, distress and 
suffering from inflamed breasts, we know can be averted by judicious 
treatment. These means we will indicate under appropriate head- 
ings. 

Inflammation of the Breasts. — Mastitis. 

For several days after delivery there is some irritation and fever- 
ishness of the system attending the appearance of the milk. This 
is popularly known as Milk Fever. Sometimes there is chilliness and 
headache, with heat, tenderness and fullness of the breasts. We 
never have trouble here, for the veratrum, which we continue after 
childbirth to ove come after-pains, is the best anti-fever remedy 
known. Since its employment we have lost sight of milk fever alto- 
gether. It is prescribed as follows: 



622 MEDICAL PRACTICE. 

1$. — Tincture of Yeratnim Yiride, . fifteen to thirty drops, 

"Water, .... eight teaspoonfuls. 

Mix. 

Take a teaspoonful every two or three hours. Do not disturb, if 

sleeping. If it has not been used previously, it may be administered 

on the third day, or when the feverish symptoms appear. 

When inflammation begins in the breast, for it seldom appears in 

both at the same time, the milk vessels (ducts) will be felt distended, 

hard and knotty. This is the "caking" and "ague," as called by 

nurses. It is accompanied by some pain and must receive immediate 

care. Commonly a proper support to the breast is wanting. This 

should be supplied by a closely fitting under-waist made of stout 

material, or by a sling passing over the shoulder. Between this and 

the breast insert a narrow piece of canton -flamn.1 or old cotton wet 

with 

1$. — Tincture of Arnica flowers, 

Tincture of Aconite root, 

Laudanum equal parts. 

Mix. 

Care should be exercised not to get the liniment on the nipple, for 
the aconite is poisonous. If it were not for the fact that handling 
increases the inflammation of the breast, bathing would be prefer- 
able. If the compress is kept wet all the symptoms disappear in 
twenty -four hours. The breast should then be supported by adhe- 
sive strips passing under the gland and secured to the chest above. 

Broken Breast, Milk Abscess, Mammary Abscess. — 
Mastodynia Apostematosa. 

From mismanage ment or carelessness the inflammation often pro- 
gresses until an abscess (boil) forms. The pain is then severe, ex- 
tending, perhaps, to the arm ; the breast is exceedingly tender, every 
motion of the body increases the pain and throbbing ensues. Sup- 
port is now more necessary than ever. The liniment should be con- 
tinually applied. Internally should be given 



GATHERED BREAST. 623 

1$. — Tincture of Poke Root, . . . one dram, 
Essence of Wintergreen, . . . ten drops, 
Water, . . ... four ounces. 

Mix. 

Take a teaspoonful every two hours. Drink but little fluid and 

keep the breast partially empty by occasionally drawing some of the 




BREAST PUMP. 

milk with a breast pump. We consider Mullan's the best. If it is 
considered advisable to dry the breast, teaspoonful doses of calcined 
magnesia should be given every three or four hours until the bowels 
move freely with copious watery discharges. Paint the breast with 
1$. — Extract of Belladonna, . . . two drams, 

Water, one ounce. 

Mix. 

And do not nurse the child while this is applied. This treatment 
is successful in weaning, or, in case it is thought best not to nurse the 
infant. If the abscess cannot be aborted by these means the treat- 
ment may be changed so as to hasten its " pointing," i r it may be 
lanced. A s:>ray of chloroform may be directed to the softened spot, 
which produces insen ibility, when it may be opened without pain. 
This affords great reli< f Keep up the use of the magnesia and the 
application of the belladonna. Support the breast, and occasionally 
empty it with the pump. 

We have just alluded to the treatment to be used in drying the 
breast in w< aning, or when it is more desirable, in cases of stillbirth. 
It seems well to say a word here in respect to the opposite condition 



624 MEDICAL PRACTICE. 

insufficiency of milk. The milk can be increased in amount by heat 
and diet. Flannels wrung out of hot water should be applied to the 
breasts and covered with oil silk or a hot bowl well titling may be 
covered over the gland and be allowed to remain until cool: th< n 
heat and reapply. The diet should be mostly fluid and consist of 
meat, eggs and milk. Beef tea is proper. We prefer soft custard 
made in this way: Bring a pint of milk to the boiling point, beat two 
eggs with sugar and stir in. Take from the stove in one minute and 
when cool, flavor. 

Sore Nipples. 

Much of the trouble caused by sore nipple may be prevented by 
hardening them during the last weeks of pregnancy by rubbing and 
by bathing with tannin and water, or by frequent wetting with 
tannin and glycerine made into a thick paste. When they be- 
come chapped and sore while nursing, they are difficult to cure, 
because of the suction and abrasion of the child's mouth and over- 
distention of the milk vessels, for the mother favors this breast and 
it is seldom if ever completely emptied. Calcined magnesia makes a 
good application and is harmless to the child. Tannin may be 
sprinkled on the sore after the child nurses, but must be washed off 
before using again. Sore nipples often produce thrush in the 
infant; in such a case powdered borax is the remedy ; both for the 
nipple and for the child's mouth. 

Change of Life, Turn of Life, Critical Time. — Menopausis. 

In temperate climates, most women cease to menstruate at the age 
of forty-five; the next most frequent time being at or during the 
fiftieth year. The critical p«-riod may be called the time from which 
irregularities begin to the time of perfect or permanent restoration 
of health. "The critical nature of a period.'' remarks Dr. Tilt, "is 
shown by its effects on the health in ensuing years. Thus puberty 
is not only the crisis of most of the complaints of the preceding 



' TURN OF LIFE. 625 

epochs, but it determines the health of the subsequent period for 
good or evil; in like manner, the change of life not only terminates 
critically many complaints of the preceding years, but it has a decisive 
action upon the state of health during the whole subsequent period 
of life; so much so, that from the manner in which this crisis is ac- 
complished, I believe it possible to predict whether, in after-life, the 
h( alth will be good or bad. Fifty-three women m whom there had 
been no menstrual flow for five years, and whose health had been 
habitually bad, spoke of their great additional strength of constitu- 
tion and this result may be taken as a rule which harmonizes with 
the popular belief. It is shown by the greater longevity of women, 
by their being less liable to sudden death and by their general immu- 
nity from disease. 

" Those who deny that the change oflife is a critical period, argue 
as if critical meant fatal. In medical language, crisis means a sudden 
change for the better or the worse, leading as often to recovery as 
to death. Instead of flowing on in smooth tranquillity from the 
cradle to the grave, the stream of life is marked by rapids, which 
have been called critical, metamorphic or developmental epochs, and 
during which an unusual predominance is acquired by one or by sev- 
eral of the organs which together form the human frame. The ob- 
ject of each successive critic d readjustment of our frame is, to in- 
sure the greatest possible amount of health consistent with each sub- 
sequent period of life." 

"It is not unusual with women," states Sir C. M. Clarke, " to refer 
all their extraordinary sensations to 'the change of life,' and to con- 
sider that, when they have thus accounted for their diseases, they 
have at the same time cured them; and in this most medical men, 
judging at least from their practice, seem to be of the same opinion.'' 

"The complaints," says Dr. Meigs, " which women at the change 
oflife often make, are frequently hushed with the unsatisfactory re- 
ply that such complaints are owing to the change of life and are like- 
ly to cease whenever the change shall become complete. A physi- ' 
cian has no moral right by his opinion to put to sleep the anxieties 
27 



626 MEDICAL PRACTICE. 

of his patient and to save himself the trouble of thinking by so con- 
cise and unphilosophical a mode of proceeding. Whenever, there- 
for', a female at this period, which is universally admitted to be a 
critical and dangerous time for her, comes to complain of symptoms 
referable to some morbid condition of the reproductive tissues, it is 
clearly our duty to give a considerate attention to her rase and not 
to dismiss her until our judgment should be fully satisfied as to the 
therapeutical or hygienical indications of the case." 

We have introduced these few paragraphs partly as being the em- 
bodiment of our sentiments and partly to call attention to the fact 
that th£ better the health while passing through this period the bet- 
ter it will be during the remainder of life. From what has been said 
it may be concluded that all symptoms need attention and that how- 
ever trifling they may stem they have an important bearing upon 
longevity. It is not intended at this place to go into full particulars. 
Valuable hints are scattered throughout this work and many of the ail- 
ments of this transitional epoch are described and tho treatment given. 
Space will not permit us to review or enter into more minute details. 
This whole matter and some others which we have felt compelled 
to introduce into this volume would be more fittingly considered in 
a book devoted exclusively to the diseases of women; and it is pro- 
posed by the author, as soon as other pressing matters will permit, to 
issue a treatise to women about themselves. 



SPINAL IRRITATION. 627 



GLASS V. 
BONE, MUSCLE AND SKIN DISEASES. 

ORDER I.— Spinal Diseases. 



Spinal Irritation. 

The spinal nerves exercise such an influence over respiration, cir- 
culation, digestion, micturation, defecation, and other muscular 
actions that it is remarkable that their irritation does not oftener re- 
ceive attention and investigation. Through this agency palpitation 
or asthma attend dyspepsia; and dyspepsia, uterine diseases. Many 
diseases have their origin in irritation of the spinal nerves; this irri- 
tation once allayed the disease disappears. We have in mind a case 
of threatened abortion with powerful uterine contractions set up by 
inflammation in other organs and the consequent reflex irritation of 
the«e nerves. We do not now consider those cases of anaemia with 
pale and bloodless skin, in which the system is insufficiently nour- 
ished and which manifests itself in chorea and similar affections. 
We confine our remarks to cases in which there is tenderness of tlie 
spine. This is easily ascertained by pressing the finger-tips into the 
flesh between the ribs close to and on each side of the spinal column. 
Places will be found in which the least pressure causes the person to 
flinch and recoil from the touch. Sometimes resting against tlieback 
of a chair will discover the sensitive spot; at others, the pressure of 
the clothing may detect the location. 



G28 MEDICAL PKACTlCtt. 

TREATMENT. 

It is wise to examine the spine in nil cnses of nervou<= irritation or 
of di-eases accompan ; ed with tremor or spasmodic action either of 
the whole system or of one of it > organs. The successful treatment 
of such diseases will be tedious at best unless this irritability of the 
spinal nerves is removed. Rapid recovery will, in all instances, fol- 
low the local treatment. We want a benumber and anodyne. This 
is furnished by 

1$. — Tincture of Aconite root, 
Tincture of Arnica flowers, 

Laudanum, ..... equal parts. 

Mix. 

Apply upon a disk of flannel covered with oil-silk or sheet-rubber, 
and secure with a pad and bandage. Wet as frequently as necessary. 
I i case of inflammation or congestion about the spine, give internally 
iodide of potassium in five or ten grain doses, three times a day. 
Thi* remedy has a special tonic effect upon those tissues of the body 
similar to the nerve sheaths. This treatment does not interfere with 
whatever means may be employed to remove the cause of the irri- 
tation. 

Curvature op the Spine, Hump. 

The column of bones constituting the spine is naturally arranged 
in slight but graceful curves to support the head upon a spring and 
prevent concussion of the brain in walking, jumping, etc. From 
impaired nutrition, as in scrofula, rickets, and f-imilar diseases, 
from pressure and remaining long in constrained postures, these curves 
an 1 augmented or distorted. Hump is of this nature, and the defornu d 
are cal'ed humpback. This is generally forward or backward. 

The Hi doo girls are gracefully formed. From iheir earliest child- 
hood they are accustomed to carry burdens on their heads. The 
water for family use is always brought by the girls in earthen jars, 
carefully poised in this way. This exercise is said to strengthen the 
muscles of the back while the chest is thrown forward. No crooked 



CURVATURE OF THE SPINE. 629 

backs are seen in Hindostan. Dr. Henry Spry says, that " this exer- 
cise of carrying small vessels of water on the head might be advan- 
tageously introduced into our boarding schools and private families, 
and that it might supersede the present machinery of dumb-bells, 
black-boards, skipping-ropes, etc. The young lady ought to be 
taught to carry the jar as these Hindoo women do, without ever 
touching it with the hands. " The same practice of carrying water 
leads to precisely the same results in the south of Spain and in the 
south of Italy, as in India. ANeapol.tan female peasant will carry 
on the head a pail full of water to the very brim, over a rough road, 
and not spill a drop of it : and the acquisition of this art or knack 
gives her the same erect and elastic gait, and the same expanded client 
and well formed back and shoulders. 

When the bones are diseased and the cushions of cartilage between 
them ulcerate, with a loss of motion of the lower limbs, we have 
Pott's disease, so called from his able description of it. A few of 
the spinal bones will be found displaced backward and the projec- 
tion is sensitive. The treatment is by the use < f those remedies that 
will improve digestion, tone the system, by exercise and by surgical 
appliances. The mechanical apparatus, to be perfect, must take the 
weight of the head and shoulders from the spine, and at the same 
time brace the angular projection. 

The most common form is lateral curvature, from side to side, im- 
perfectly repr. sented by the letter 8. This is not so much due to any 
disease of the bones as to debility and relaxation of the cartilages 
and muscles. Girls are the most common sufferers, particularly the 
sedentary, and those accustomed to luxury and indolence. The 
awkward postures assumed in learning to read and write, carrying 
heavy weights on one arm and misses' corsets, are prolific causes. 
The first noticeable feature is a raised shoulder. If the curvature is 
great, the internal organs are displaced and crowded, and become 
disease" 1. Consumption not unfrequently follows. The treatment 
consists of proper diet, exercise and mechanical apparatus. In spinal 



630 



MEDICAL PRACTICE. 



deformities the advice of a skilled surgeon should be promptly sought 
and carefully followed. 




SHOULDER BRACE, STEEIi-SPRINO BACK. 






Backache, Lame Back. 

Very many diseases and diseased conditions occasion a dull heavy 
pain in the back. It may be near by as in spinal disease, or^ rheu- 
matism of the muscles of the back, but more commonly it is distant, 
as in dyspepsia and womb diseases. The kidneys are not unfre- 
quently disordered. In fevers the skin is dry and inactive and these 
organs are compelled to do double duty to carry away the impurities 
in the blood, and as a result, the back aches. This is the cave al o 
when over stimulated by alcoholic liquors, tobacco, eU-. Colds 
contract the skin, irritate the kidneys and produce t'.:is affec ion. In 
the majority of cases, however, it is a symptom of nervous exhaustion, 
increasing toward the close of the day, as the body becomes tired. 
This may arise from anxiety, brain-work, excitement, marital ex- 
cesses or sedentary habits with deficient exercise. 



AFFECTIONS OF THE KNEE-JOINT. 631 

SlDEACHE. 

Sideaclie may have several causes, as rheumatism, inflammation or 
congestion of the liver, spleen or lungs. If the pain is in the upper 
part of the chest it is likely to be from the lungs. If on the right side 
low down, then probably the liver is the cause, and if on the left side it 
may be the spleen. It may also be caused by sedentary habits, ex- 
haustion i r sprain. 

TREATMENT. 

The best remedies are the Turkish or spirit-vapor bath, with fric- 
tion and moderate gentle exercise, the very best care and training of 
the parts affected and medication directed to the organ affected. 

Knee-joint Disease, Swelling of the Knee. 

From sprain or other injury to the knee and from inflammatory dis- 
eases of the structures, this joint is liable to swell and become drop- 
sical, or otherwise impair walking. 

treatment. 
No matter of how long standing, begin treatment at once by a poul- 
tice of lobelia leaves and hot water. Envelop the whole joint and 
cover up well with flannels. A spirit-vapor bath with the rubber 
bag an 1 alcohol is next in order. This should be prolonged for an 
hour and followed with thorough washing wiih soap and water and 
hard friction over all the body. Make the whole surface glow. Re- 
move the pack and have the knee and whole leg rubbed with the hand 
for fifteen minutes. Then oil the leg, using the antiseptic balsam or 
lard, and rub for another quarter-hour. A double thickness of 
flann- 1 may then be sprinkl-d with 
I?.— Olive Oil, 
Sassafras Oil, 
Aqua Ammonia, 
Camphor Liniment, of each one half ounce. 

Mix. 

And bound about the joint. Repeated for two or three days, 
this plan of treatment will cure most every swelling of the knee. 



G32 MEDICAL PRACTICE. 



ORDER II DISEASES OF THE SKIJST. 

The skin is composed of a variety of parts or organs: (I) the epi- 
dermis or horny layer; (2) the eorium or true skin; (3) the loose 
tissue, usualiy containing fat, which lies beneath the true skin; (4) 
the nerves; (5) the vessels ; (6) the sweat and oil glands; (",) the hail 
and nails, usually called the appendages. 

The Epidcrmi*, Scarf-skin, or Horny Layer. — When a part of the 
surface of the body, e. g., the palm of the hand, is blistered, two 
layers of the skin are separated by a quantity of watery fluid. The 
layer which is raised up is the scarf-skin. It is not at all sensitive, 
and may be cut, just like the hair and nails, without pain. The 
epider iiis grows on ihe surface of the true skin, and is moulded over 
all iis inequalities under this is the coloring matter, upon which de- 
pends the vaning complexions of individuals and races. The most 
powerful single cau-e affecting the amount of coir is light, the 
intenser the light, the deeper the color. Many people have freckles 
in summer who appear to have none in winter. 

The Corium or True Skin. — This is a tough ela-tic structure, made 
up chiefly of bundles of fibres, which interlace in all directions. The 
deeper parts are loose and, as a rule, contain fat; the parts nearer to 
the epidermis are extremely dense. The surface of the true skin is 
studded with myriads of very small pointed projections called papil- 
Ice, whose average length is about one-hundredth of an inch. It is to 
thest: papillae that the sensitiveness of the skin, as an organ oi 
touch, i> chiefly due. They are most numerous on the palms of ihe 
hands, on the fingers, and on the soles of the feet, where they are 
arranged in lines and curves, hence the characteristic appearance of 



ANATOMY OF THE SKIK 633 

the skin in those parts. Each papilla is supplied with blood by min- 
ute arteries, and in most of them a little nerve-twig terminates. Al- 
though the papillae are the organs of touch, they are not intended to 
be brought directly in contact with external objects. When this is 
done, as when the epidermis is removed, the result is merely a pain- 
ful sensation. The papillae require to be covered with a certain 
thickness of non-sensitive horny layer. 

In the substance of the true skin, and even deeper, the various 
glands and the hair follicles are lodged. 

The Sweat Glands. — Over the entire surface of the body is avast 
number of very minute openings or pores. They are largest and 
most numerous on the palms of the hands, and the soles of the feet, 
where they can be seen with the naked eye. On other parts of the 
body they are smaller and less numerous. These pores are the open- 
ings by which the secretion of the sweat glands is thrown out. The 
swe.t glands are situated in the deeper layers of the skin, chiefly 
amidst the sub-cutaneous fat. They consist mainly of a coil or tube; 
in the form of a ball, with a duct or drain leading from it to the sur- 
face. Each gland, taken by itself, is small and unimportant, but, 
taken together, they form an organ of the greatest consequence in 
the animal economy. It has been estimated that there are, on the 
average, twenty-eight hundred pores of these glands to the square 
inch, and that the total length of the tubes in the body amounts to 
nearly tweniy-eight miles. They remove from the system about 
twenty ounces of waste matter every twenty-four hours. 

Tlie Oil Glands. — Besides the sweat glands, the skin contains an- 
other kind of gland for secreting an oil or ointment by which it is 
kept soft and flexible These are the sebaceous or oil glands. They 
are distributed over the surface of ihe body, but are most numerous 
in parts largely supplied with hairs. These glands are composed of a 
collection of pouches filled with a whitish substance like a soft oint- 
ment and communicate with the surface by a duct or dram which 
opens most frequently into the cavity or follicle m which a hair grows. 

Tlie Hair and Nails. — Both these structures are produced by a modi- 



634 MEDICAL PRACTICE. 

fied growth of the scarf-skin. The hair consists of an outer covering 
of scales which overlap each other, like the slates on a house, a middle 
layer of fibres like a piece of wood, and a substance called the pith 
in the centre. 

Pimples. 

The oily secretion is contained in the oil gland just as the soft scarf - 
i-kin is formed on the surface of the true skin. First of all, soft 
round cells are formed, containing a large quantity of oil. These 
are pushed from the lining of the wall of the gland toward the mid- 
dle of its cavity. Here they burst, the oil is set free, and the minute 
p- niches co lapse into scales. By the continuous formation of other 
cell-, behind it, the oil\ r substance is driven along the duct and ap- 
pears on the surface. Sometimes, in certain states of health, the se- 
baceous substance becom s too dry to flow out. It then remains in 
the gland, gradually distending it, with or without inflammation. 
When there is no inflammation, the plug of ointment ultimately 
shows itself on the surface, and takes on a black bead from the 
smoke and uirt in the air. This is the so-called "' grub'' which may 
be squeezed out betw T een the finger-nails. When the retentions of 
the contents of the follicle is accompanied by inflammation, the 
result is a crop of pimples, " spotted acne " about the nose and fore- 
head, and on other parts where the oil glands are numerous. 

Pimples on the Face. — Inflammation of the oil tubes and glands, ex- 
tending more or less to the neighboring skin, gives rise to a well- 
known eruption of tlie forehead, face, die^t, and back called acne. 
When the pirn; les have the black lead of a "grub" at the point, 
they constitute spotted acne. There is a variety which affects the nose 
and its immediate vicinity, and is usually associated with excessive 
indulgence in alcoholic stimulants, although it may, and often does, 
arise from other causes in the most abstemious. It always annoys 
the afflicted, and may be the cause ot serious loss in business or 
otherwise, owing to the prejudice which it excites. This is always an 
obstinate complaint, but may be improved by strict attention to the 



CAUSES OF SKIN DISEASES. 635 

various functions of tne body and by fresh air and exercise. To get 
rid of the unsightly appearance something more is necessary. The 
"grubs" should be squeezed out. This can be done, as a rule, by the 
linger nails, before the glass. During puberty they develop from re- 
flex irritation of the genitals. There are sebaceous glands in the 
throat which also become affected and change the voice. This 
change, the sore throat and the pimples are important in exposing the 
more than probable origin. When this fact becomes better known 
the duties of parents and instructors will be more clear and obliga- 
tory, and ils criminal non-performance more flagitious. 

Wens. When the secretion is completely retained, and prevented 
from coming to the surface, which rarely happens, the oil gland and 
its contents form a kind of tumor, which is seen most frequently on 
the scalp. These are the "wens" which are sometimes allowed to 
grow to such an enormous size. They are easily dealt with by the 
surgeon, and should always be removed. 

Offensive Odors. There is in the perspiration an odorous substance, 
which in people of cleanly habits is not disagreeable, but which is 
very apt, especially in those of sedentary habits, to become offensive; 
and people who live together, and value one another's respect and 
affection, cannot afford to run the risk of becoming objects of mu- 
tual disgust. 

Causes op Skin Diseases. 

We have seen that the skin is the organ of sensibility and touch, 
besides being an integument or covering to the parts that lie under- 
neath. It has a wonderfully complicated structure, owing to the ar- 
rangement, in varying proportions, of scarf-skin, true-skin, fat and 
cellular tissue, nerves, blood-vessels, sweat and oil glands, hair and 
mils. This org m has important work to do in perforin mg its part 
among those processes which taken together we call the life of the 
body; and, like all hard-working and complicated machines, it is 
liable to get out of order. The derangement from which it suffers 



636 MEDICAL PRACTICE. 

may be the result of unhealthy action of some internal organ or or- 
gans, or they may arise in itself from external injury or irritation. 

1. Among the most commonly recognized of the internal or con- 
stitutional causes of diseases of the skin are: — 1 The transmission 
from parent to child of a tendency to certain forms of disease. This 
is well seen in the infant children of parents who have suffered, one 
or both of them, from a common contagious disease, unless the dis- 
ease has bee n completely eradicated. When we consider how exact- 
ly the complexion and the texture of the skin in the parent is some- 
times copied in the child, we need not be surprised at the transmis- 
sion of such diseased conditions, nor that here also the sins of the 
fathers are seen to be visited upon the children. 

2. Some kinds of food have a tendency to produce diseases of the 
skin. For example, all liquors containing alcohol, when taken in 
excess, produce a change in the texiure of the skin in general, and 
on that of the nose and contiguous parts in particular. Some kinds 
of shell-fish and fruit produce nettle-rash. And there can be no 
doubt that many other substances, taken as food and drink, although 
they do not act in such a marked manner as those just mentioned do, 
in course of time, also produce their deleterious effects upon the 
skin through internal organs. 

3. T<.mpor;.ry derangement and actual organic disease of internal 
organs, are the chief of the internal causes of disease of the skin. 
The changes in the skin and the internal troubles may arise from the 
same cause, or they may react upon one another. The organs whose 
derangement especially incite or intensify diseases of the skin are the 
stomach, the liter, and the kidney*. As regards the stomach, if there 
is an excess of aeid secretion, or when there is some other change 
from the standard cf health, then, owing to the absorption of acrid 
substances, inflammations and congestions aie produced or existing 
ones intensified. This fact is, no doul t, at the root of the preva- 
lence of skin diseases among children in their first years. The 
anxiety to give sufficient nourishment leads to a habit of constant 
stuffing, so that quantities of food are supplied out of ali proportion 



CAUSES OF SKIN DISEASES. G37 

to the requirements of the system, or the digestive power of any- 
normal stomach and bowels; consequently, a large amount of only 
partially digested aliment is absorbed, leading to internal derange- 
ments in the first place, and then to skin affections. The liver and 
kidneys both bear much the same relation to diseases of the skin. 
Each has its functions to perform in withdrawing from the blood 
certain waste matters which, if allowed to remain in the circulation 
to any extent, produce marked symptoms of disease. It is found, for 
instance, that in the wet tetters (eczema) of children the blood con- 
tains bile products, though not to such an extent as to give rise to the 
jaundiced appearance; and the retention in the blood of certain 
waste pr< ducts which it is the function of the kidneys to remove, 
gives rise to some of the skin diseases, particularly to nettle-rash and 
circumscribed congestions. 

II. A great authority on diseases of the skin, has said: "Much 
more potent in the generation of diseases of the skin than the inter- 
nal causes, which have their seat in the organism itself, are those 
agencies which are external to the body." Of these agencies, the 
following are the m< st active: 

1. " Want of cleanliness and general negh ct of the skin amongst 
the children of the poorer classes is a most fertile source of skin dis- 
ease. We meet w itli examples every day of eczema and other erup- 
tions of the scalp, mainly produced by neglect, accumulated dirt, and 
pent-up secretions.'' 

2. Irritating applications to the skin. This may include drugs, 
soaps, and the so-called "salves," many of which are made with 
rancid fat in some form or other. Sulphur is frequently the cause of 
skin diseases when it has been employed as a remedy for them. 
Then there are the irritating substances used in various trades, which 
produce the so-called bakers' itch and grocers' itch. 

3. Animal and vegetable parasites are among the common causes 
of skin diseases, e. g.,the itch-mite which produces the common itch, 
an 1 the fungus which gives rise to one of the forms of so-called ring- 
worm. 






638 MEDICAL PRACTICE. 

4. Changes of temperature also produce diseases of the skin, well 
illustrated by chapped hands and chilblains. 

Our skin then becomes diseased chit-fly from injury or irrita- 
tion applied directly to it, as also owing to disease in some internal 
organ, with all of which it is closely connected, although with some 
more closely than others. Yet, one of the commonest of formulas 
by which a Bildad, the Shuite, seeks to comfort a Job of our acquain- 
tance w ho has been smitten with " sore b ils," is that " It is better out 
than in." What " it" may be he does not very precisely state, but 
we may suppose he alludes to some poison in the blood whose evil 
workings are less likely to leal to serious results in the light of day, 
than if wrought in the dark unknown of the inward parts. There is, 
as we have seen, a "soul of truth" in this for the most part erroneous 
maxim, but a very weak, attenuated soul indeed — strong enough, 
however, to animate a vast body of injuious practices. One often 
sees little children who hive suffered for weeks from some of those 
frightfully itchy tetters, the result, almost invaiiably, of some error 
of diet or external irritant, while there has been a complete neglect 
of all means of remedy, just because "it is better out than in," or 
" it's only teethinz.'' But one of the absurdest of all the applications 
of this maxim is to the cases in which an eruption has been produced 
by the voluntary use of a known irritating subslance. It is a well- 
known fact, that if you apply an irritant to the skin an eruption will 
follow. Even pure water, if applied pr< tty constantly to a part, will 
give rise to a crop of watery and mattery pimples. It is this fact, 
taken along with erroneous notions concerning the functions of the 
skin, that appears to have given rise to the most irra ional of all the 
forms of the so-called "hydropathic treatment" of disease. Some 
people, by the use of waterproof clothing, to prevent evaporation, 
actually submit to the constant contact of a stratum of water or of 
w T et clothes to the skin until a copious eruption is produced, and then 
they point with satisfaction to the rather loathsome result, convinced 
that they must be better, because " if it had not been in, it would n t 
have come out," The fact is they have merely employed a mechani- 



RASH AND PIMPLES. 639 

cal irritant to a sensitive organ of the bocty, and produced the injury 
which was to be expected. They might as well have scratcfied them- 
selves until the same result was obtained. 

The diseases of the skin are too nu rerous to describe or even men- 
tion. We can give space to but few and only point out a general 
line of treatment. 

Erythema is simply a reddish blush of the surface resembling the 
mark left by a blow with a whip. It is significant of indigestion in 
children. 

Roseola, or rose rash, is a reddish blush more extensive than the 
other, appears in circular patches on the face, neck and arms. The 
color may deepen or suddenly disappear. Some name it false mea- 
sles. 

Urticaria, nettle-rash, teething-rash, hives, prickly-hea f , red-gum, 
white-gum, and milk spots are all about one and tie same thing. 
There is a reddish blush with white or red points or elevations thickly 
studding it, or the red may be confined to the base of each spot. 

These three diseases are chiefly met in children, but if in adults, 
they indicate internal irritation most commonly from the quality of 
the food or its imperf< ct digestion. They are accompanied with in- 
tolerable itching, particularly if the person is warm, and this consti- 
tutes the only symptom demanding attention. The diet should be 
plain and the meals ligh^. Give small doses of calcined magnesia at 
night and bathe with soda and w. ter. If the skin is broken by 
scratching, apply antiseptic ointment. 

Most skin diseases develop pimples or vesicles. These are divided 
into watery, mattery, dry and scaly. We will notice them in the 
order named. 

Scabies, itch, bakers' itch, barbers' itch, growers' itch, etc. These 
have the watery pimples and attack the hands a d the web between 
the fingers principally. Barbers' itch is seated on the chin and lips. 
Itch follows th handling of irritatimr sub-tances and the introduc- 
tion of an insect of microscopical proportions. It is transmissible. 



640 MEDICAL PRACTICE. 

Treatment. With the destruction of the parasitic animal the 
disease disappears. Cleanse and soften the skin thoroughly with 
soap and warm water. Then rub in and keep the parts wet with 
1^.— Carbolic acid, thirty drops, 

Glycerine • two ounces. 

Mix. 

In barbers' itch it may be best to remove the hair. This can be 
done without pain by whitening or freezing the part with a spray of 
ether or chloroform. The hairs may then be grasped singly with 
the forceps near the skin and extracted. It simplifies the process to 
cut the hair to the length of a q arter of an inch. 

Herpes, tetter, shingles, ringworm. \Ve have heard other forms of 
skin disease called ringworm; we have also heard herpes called 
salt-rheum. It is not to be rxpe> ted ihat the people would agree 
when physicians differ sometimes on these points, so various are the 
presentations. In herpes the watery pimples appear on au in- 
flamed surface in distinct clusters. Their common seat is the back 
of the neck or the waist. They spread < r appear in successive crops. 
Shingles about the waist arc dreaded, the popular belief being that if 
they meet around the body, death is certain. This is an error. The 
patient is feverish and has pain in the abdomen. Locally apply the 
carbolic acid lotion just given, adding four ounces of water; inter- 
nally a cathar.ic of calcined magnesia and the Queen's Root 
syrup. In ringworm the pimples appear unin d in a ring er in rings, 
one within the other, but not touching. Bru^h with spirits of tur- 
pentine. 

Eczema, moist tetter, milk crust, scalled head. Here we have 
little watery vesicles closely crowded together. The fluid contents 
eseapes and forms thin yellow or green scabs. In the hair these 
scabs hold firmly and in an attempt to remove them while dry, the 
hair is uprooted. In case of crusts, moisten with glycerine and keep 
washed with castile soap and water. Keep the bowels soluble with 
calcined magnesia. If the sores are wet wiih a mixture of tannin and 



PUSTULES AND DRY PIMPLES. 641 

glycerine it will all.iy the itching. Long standing cases need medical 
advice. 

Pemphigus, watery blebs. These are large blisters, come on any 
part of the surface, have red edges and are separated by healthy 
skin. Blebs sometimes matterate, crust over and ulcerate. It is then 
named Rupia. 

Pustules or mattery pimples are distinguished from tlie watery variety 
by th" fact that they contain pus, a yellowish-ichite fluid. 

Impetigo, running or crusted tetter. This attacks all ages, but 
chiefly children. The vesicles are small and crowded together as in 
eczema, but are yellowish and upon an inflamed base. Sometimes 
the base has the appearance of erysipelas. Yellow or greenish crusts 
form; and if removed while scratching, soon re-form. When of long 
standing no traces of the original pustules are left. 

Treatment. Keep the part well cleaned and soft, and use the 
following lotion : 

IJ. — Carbolic acid, one dram, 

Acetic acid, two drams, 

Glycerine, . . . . .four drains, 

"Water, ... ... eight ounces. 

Mix. 
Use as a wash three or four times a d;iy. Remedies for improving 
the blood are advantageous and often necessary. 

Ecthyma or papulous scall, c^sely resembles pemphigus in size, 
general shape and distribution, but they are pustulous and the bases 
are inflamed. Greenish brown crusts soon form and closely adhere 
to the skin. Attention to cleanliness diet, and the removal of or- 
ganic or constitutional diseases constitutes the treatment. 

The papulose class is that distinguished by dry pimples. The eleva- 
tions contain no fluid. Red gum is an example. They are noted for 
their intolerable itching. In Prurigo the eruption is not very distinct, 
but the smarting, tingling and prickling is very severe. Many times it 
attacks the vulva of the female and scrotum of the male. It is often 



642 MEDICAL PRACTICE. 

obstinate of itself, but is aggravated by cutting the flesh with the 
finger-nail, by irritating discharges and by complication with ecze- 
ma or erysipelas. It occurs among women that are enciente or pre- 
cedes the menstrual period. Heat increases it and cold allays the 
itching, but only temporarily. In some cases a solution of sulphur- 
ous acid in water, as much as it will dissolve, makes a kind lotion. 
A prescription more popular among physicians is the following : 

I£. — Powdered Borax one-half ounce, 

Morphine, . . . . . . ten grains, 

Carbolic acid, .... thirty drops, 

Rose water, , 'one-half pint. 

Mix. 
Bathe three times a day and allow to dry on. During the intervals 
powder with starch. 

In Lichen, the points are red or purplish and may occupy a small 
space inflamed and well defined, may appear in patches or cover the 
whole surface. It occurs most frequently in the aged and those ex- 
posed to great heat. Boracic acid solution applied three or four 
times a day with a soft sponge is the treatment. 

The Lancet gives a recipe for Prickly Heat which w T ill meet the 
milder forms of these itching diseases. 

V,. — Oxide of Zinc, one dram, 

Oxide of Magnesia, .... three drams, 
Flowers of Sulphur, .... two ounces. 

Mix. 

"This is to be used morning and evening in the following way: 
The dry powder being on a plate, a wet sponge is then pressed down 
on it, and a little will adhere; this firmly rubbed on the parts af- 
fected, fresh moisture and powder being from time to time supplied, 
the application being continued from ti n to fifieen minutes at each 
sitting. The parts are then washed. I have never seen the worst 
cases last beyond four or five days. No smarting attends the use of 
this remedy, and after the first application itching is practically at 
an end." 



DANDRUFF. 643 

The squamous or scaly eruptions receive the general medical terms 
Lepra, Psoriasis and Pityriasis. 

In Leprosy the crusts are whitish, silvery, thin at first, but become 
thick. The patches may be distinct and circumscribed by a red line 
or may spread. Sometimes the scales are black and blue. la. Psori- 
asis the patches are more level, not depressed in the centre, are irre- 
gular in shape, not round and rough, not smooth, and the skin appears 
chapped. With Pityriasis we are all familiar. In the hair, its most 
common location^ it is called dandruff. It is not so well known that 
other parts of the body, those not covered with hair, maybe affected. 
This is so common that we will consider it at length. 

Dandruff. — Pityriasis Capitis. 

An affection of the scalp in which fine scales are continuously 
formed and thown off. There is no pain, no crusts, and only occa- 
sionally itching. No age is exempt. The head is found to be dry 
and hot, caused by indigestion, excesses and other diseases and con- 
ditions producing a low grade of fever, or it may be traced to me- 
chanical causes; the use of unclean brushes, of false hair with their 
fungi, too much stimulation of the scalp by excessive brushing, and 
the use of strong alkalies and other remedies sold to prevent the 
complaint. No ill results follow; in fact the principal feature seems 
to be the annoyance caused by the continual presence of the white 
scales in the hair and their deposit upon the dress, coat collar and 
shoulders, particularly to persons making any pretensions to neat- 
ness. 

Treatment. Borax, carbonate of potash, lead and similar drugs 
are not beneficial, nor are the many preparati ns of castor oil, 
because the former add to the dryness that is alread} r present and the 
latter make the dandruff less conspicuous, only to reappear when 
the superabundance of oil is wanting. A better local application is 
1$. — Sublimated Sulphur, . - . . two drams, 

Sulphate of Zinc, two drams, 

Rose Water, one pint. Mix. 



644 MEDICAL PRACTICE. 

Shake and apply with a clean brush or sponge every two or three 
days. 

A previous application of carbolic acid well diluted in water may 
be necessited if fungi are present. False hair should be boiled in 
borax and water. Dyspepsia needs attention and the body should 
be kept cool and cleanly by daily baths. 

Salt Rheum is a name much used by the people, but unfortunately 
is given to so many forms of skin disease that it is impossible for a 
physician to discriminate. The experience of others differs from our 
own. In our observations we have found it more commonly assigned 
to the scaly tetter — psoriasis. The treatment in such a case would be 
the same as for psoriasis; locally the aniiseptic or white ointment 
and internally the Queen's Root compound. 

Observations. — It is painful to think how manj T mothers absolutely 
refuse to cut their children's locks, or try all sorts of shifts to avoid 
the dread alternative, however much diseased the scalp may be, or 
however filthy the hair. Another prejudice, more difficult to com- 
bat than even maternal notions of the aesthetic, is the belief that there 
is some danger in healing a tolerably extensive skin disease, espe- 
cially one affecting the scalp. There is a fear of convulsions, which 
has been proved groundless again and again. One great German 
authority in the treatment of skin diseases observed many thousands 
of such cases closely, aid m ver found any connection between them 
and nervous disease. If it is fits you are : fr.-.id of, does it not stand 
to reason that the constant itching irritation of tl e diseased part, and 
the consequent sleeplessness and loss of general health, are fully as 
likely to lead to nervous troubles as the healing cf the disease by 
means directed both to the constitutional state and to the affected 
skin? 

Na>vu8, mother's mark and moles, must be referred to the surgeon 
for treatment. Lupus or superficial cancer, is described in another 
pari of this volume. (See Index.) 

Tan or sunburn may be removed by spreading on a paste made of 



DISCOLORED SKIN. 645 

magnesia and milk or glycerine. In a few minutes remove by wash- 
ing with castile soap-suds and rinsing with water. 

Fi'eckles are deposits of pigment or coloring matter caused by heat. 
Tiiey are objectionable because they destroy the beauty of the face. 
The French women, who carry heating pans for warming the legs, 
have freckles upon the legs. Blisters oti brunettes cause darker de- 
posits, which are permanent. For freckles, rub frequently with 
lemon juice and allow to dry on. Wash with borax water. In more 
obstinate cases, carefully louch each spot with a camel's-hair brush 
moistened with a solution of chloride of lime ten grains, and water 
two to four drams, according to the sensitiveness of the skin. 

Liver spots, liver stains, (Chloasma) have nothing to do with the liver, 
but are caused by unclcanliness, wearing flannels too long without 
change, or by contagion. It is caused by a vegetable parasite which 
grows under the scarf skin. The patches appear chiefly upon the 
chest, abdomen, upper arms and neck, are circular or run together, 
forming irregular shapes, and of a y< llowis?h-brown color. Their 
only annoyance arises from a knowledge of their presence and their 
itching when heated. 

Treatment. Change the under-clothing frequently. Dismiss the 
belief that there is any special virtue in flannels that are worn until 
they rot or almost reek with filth. 

Bathe the whole body daily in strong soap-suds, using a flesh-brush. 
To the affected part apply a lotion of diluted sulphurous acid, car- 
bolic acid, ammonia, or 

$.— Corrosive Sublimate, . . . five grains, 

Alcohol, four ounces; 

Mix. 

Rub on with force once or twice a day. It is poisonous; be careful. 

It may be considered out of place to introduce the subject of lice, 
but the filth and itching suggested it. Although " born and bred " 
among the filthy, these little animals too often emigrate to the scru- 
pulously cleanly. There are several kinds, and each, preserves its 



646 MEDICAL PRACTICE. 

identity. Head lice and "crabs," only inhabit parts of the surface 
covered with hair, while body-lice dwell in the seams of garments 
and travel the skin for food. The former are the pests of the school- 
room, the dormitory, and other places where persons are closely 
cr -wded and cU anliness is the exception. The latter infest camps, 
prisons, tenements, street cars, etc. For lice in the hair, soak one 
ounce of larkspur seed in a half pint of alcohol, for a day. Thor- 
oughly wet the hair at bed-time every other night. Two or three 
applications are all that are necessary. The hair may then be cleansed 
with borax water. Body lice are destroyed by attention to the 
clothes. AH the clothing should be changed daily and either boiled 
or baked. Two full suits alternated in this way for several days are 
effectual. Bathe the body daily and use the flesh-brush. 

Ringworm of the Scalp. — Porrigo. 

The vegetable parasitic diseases are caused by the development of a 
fungus, chiefly on the parts covered with hair. By a fungus is not 
here meant a toadstool, but a very minute organism which, owing to 
certain similarities in the mode of reproduction, is ranked in the veg- 
etable kingdom with the fungus. The fungus grows round and into 
each hair, just as ivy does about the stem of a tree. 

The commonest of these diseases is the ordinary ringworm of the 
scalp. Whenever the disease is observed, efficient measures should be 
taken to cure it, instead of wasting time with some of the feeble pop- 
ular remedies, such as ink; thus permitting the affection to spread 
and become established. The hair should be cut off for half an inch 
around each patch of ringworm. Get a small camel's-hair brush, and 
a solution of the following composition : Iodine, thirty grains ; 
colorless oil of tar, two drams. Apply the solution carefully with 
the bru?h to the diseased part only. Repeat the application in a week. 
It is a most obstinate disease, and requires the exercise of great 
patience. Children suffering from ringworm should not be much 
confined in the house. 



LOSS OF THE HAIR 647 

Baldness. — Atopetia. 

The cavity in which the hair grows is a depression in the skin, 
with a projection at the bottom, and may be compared in this res- 
pect to a bottle. The projection is the papilla of the true skin, on 
which the modified scarf-skin is formed, of which the hair consists. 
Now if this papilla be destroyed, or if such a change comes over its 
blood-vessels or nerves, as to make growth of hair impossible, it is 
clear that any attempts to restore the hair will be fruitless. You 
might just as well apply a salve to the gums in hope of producing a 
third set of te.th, as keep rubbing "hair-restorers" over the scalp 
where the follicles have been destroyed either by injury or by natural 
decay. When the hair has fallen out, having the surface smooth 
and bare, like a white kid glove, as sometimes happens, no success is 
likely to attend any endeavors to restore the growth. When, how- 
ever white downy hairs remain, there i?, as a rule, fair ground for 
expecting ultimate success. The principle upon which all outward 
applications are made is the stimulation of the surface, so as to bring 
a larger supply of blood to the part, and thus to cause a more rapid 
growth of every tissue. Thus the hair brushing which it is hoped 
will remove dandruff, stimulates the skin and produces a more rapid 
growth of dandruff. The same simulation tends to more rapid 
growth of the hair. All irritating substances — mustard, hartshorn, 
cantharides, etc. — have the same tendency. The youth, ambitious 
of possessing the facial aspect of manhood, is recommended by his 
knowing friends to rub his cheeks and upper lip with a preparation 
of Spanish fly. The result which he hopes for has been known to 
follow, to some extent, in the other sex, the application of a mustard 
plaster for a sore throat. In convalescents from fevers and in anaemic 
individuals what is wanted is a combination of mild stimulants and 
astringents, and in stearrhcea, where the sebaceous glands are distended 
and plugged with hardened oil, alkalies and solvents. Excitement, 
brain-work, sedentary confinement, the use of stimulating foods and 
beverages, and venery, keep the head hot and destroy the hair bulbs. 



648 MEDICAL PRACTICE. 

"When these are wasted away or cease to be productive no treatment 
can renew their fruitiulne-s. On the other hand, if by the aid of a 
powerful magnifying glass thin delicate hairs can be detected the 
chances of restoration are favorable. 

Erysipelas. 

Erysipelas is a peculiar form of unhealthy inflammation attacking 
the skin and cellular tissue, deriving some of its peculiarities from 
the structure invaded, having a strong tendency to spread or diffuse 
itself with great rapidity by continuity of surface. It may extend 
itself over any continuous surface of the skin. The areolar tissue, 
the mucous and serous membranes, the lining membranes of arteries 
and veins, and lymphatics, are all liable to be attacked by it. It 
may affect any surface, either external or internal. No period of 
life is exempt from its attack, though children are more rarely 
affected than adults. The face, which is its most common location 
in the adult, is seldom affected in children. Some persons seem to 
be predisposed to the disease, the most superficial injury being fol- 
lowed by it. It is considered as bting a zymotic disease in which 
there is a blood-poi on. The disease is an effect of debility. 

The cutaneous or simple, is the mildest form of the disease, com- 
mencing with chill and flushes of heat, followed by headache, nausea, 
hot skin, quick pulse and coated t< ngue. In from twenty-four to 
forty-eight hours, the rash makes its appearance, though sometimes 
it comes out simultaneously with the constitutional disturbance. The 
rash is of a uniform, vivid, ro«y-red hue, sometimes becoming dusky 
and always disappearing on pressure, accompanied by puffy swelling, 
caused by serous effusion into I he cellular tissue, severe burning, 
stinging pains and dropsical swelling. The ordinary duration of the 
simple form of erysipelas, is from seven to fourteen days. Some 
times it is followed by abscesses. 

Phlegmonous erysipelas differs from the cellular by the greater in- 
tensity of the inflammation and the depth to which the tissues are in- 
volved. The pain is pungent and burning though it may soon as- 



ERYSIPELAS. 649 

sume a throbbing character. The swelling, at first soft, diffused 
and admitting of distinct pitting, soon increases and becomes tense 
and brawny, the skin being evidently stretched to its full extent and 
the limb appearing, perhaps, to be double its natural size. If the 
disease runs on, suppuration of the part, pain, swelling and redness 
diminish, giving rise to an apparent though deceptive appearance of 
improvement in the patient's condition. The skin becomes darkly 
congested, and the part, instead of being tense and brawny, has a 
somewhat loose, soft and boggy feel, communicating a semi-fluctua 
ting doughy sensation to the fingers. This change is indicative of 
the formation of pus. 

Diffuse inflammation of the cellular tissue or cellulitis, invariably 
arises from a wound, often of a very trivial character. It is especial- 
ly apt to follow any inoculation of animal poison, as dissecting 
wounds, stings of insects, the bites of venomous reptiles. In what- 
ever way arising, it is characterized by the rapidity and extent of the 
sloughing of the affected tissues, and by great depression of the 
powers of the constitution. A rapidly increasing swelling appears, 
its surface tense, shining, and usually pale, feels hard, resisting, but 
frequently yields a semi-elastic sensation, hence it is called boggy or 
quaggy. There is severe pain of a burning, throbbing, or heavy char- 
acter; tensive pulse, frequently sharp and jerking, having no force or 
steadiness; countenance anxious and haggard, mind irritable, and, at 
times, delirium. The disease contracted from an injury is much more 
dangerous than the other forms noticed above. In any form, it is 
more dangerous at cither extreme of life. 

It is distinguished from other surface inflammations by its begin- 
ning in a small circle or ellipse about the size of a coin and spreading 
uniformly in all directions. DaCosta remarks that he has seen 
• mumps mistaken for it. The presence of the contagion, or the pain 
in movinir the jaw, or the limit to the redmssof the skin, will easily 
differentiate it. In inflammation of the lymphatic glands there will 
be found a number of small and separate red streaks running in the 
direction of these glands. 



650 MEDICAL PRACTICE. 

The indications are to relieve the intestinal tract of all impurities ; 
to neutralize the blood-poison; to relieve the local pain and swelling; 
and to tone up the system. 

TREATMENT. 

The administration of a remedy that will induce a free watery 
movement of the bowels, is of the greatest importance in beginning 
treatment. AVe give preference to a powder composed of 

~B,.— Podoph) llin, two grains, 

Cream of Tartar, .... two drams. 

Mix thoroughly and give one-half wiih molasses or s\rup at bed- 
time and the remainder after the morning lunch, and then e op. 

The tincture of muriate of iron in five or ten drop doses should be 
given every four hours. To save any unpleasant effect upon the 
teeth or mouth the dose should be mixed with a third of a tumbler 
of water and taken into the mouth by a glass tube, the end of which 
lies well back upon the tongue. Two hours after each dose a two or 
three drop do=e of veratrum should be given in a teaspoonful of wa- 
ter. Both these remedies neutralize the blood poison. We have 
little if any faith in the common practice of circumscribing the local 
iuflammation by painting with iodine. Repeatedly has it overstepped 
this barrier in a single night. 

That remedy which acts directly upon the poison and which has 
an immediate effect upon the congested blood-vessels is veratrum. 
There are two methods of application. First: Having some in a 
saucer or preserve dish, paint the inflamed surface as frequently as 
every half hour with a soft camel's-hair brush. "When the brush is 
not easily had, use in its place a bit of cotton cloth, the edge of 
which has been frayed to the depth of half an inch, binding it 
around a stick the size of a quill, fastening it ; and with this smear 
the surface. Or, tike a piece of cotton cloth of two or three thick- 
nesses and a little larger than the inflamed part to be covered and 
immerse it in the veratrum and apply. Repeat the application as 
often as it dries. The admixture of a little glycerine to the veratrum 
will prevent its drying too quickly. 



BOILS. 651 

As a tonic for dark-complexioned persons, the iron as above indi- 
cated may be continued through convalescence. For others the use of 
the golden seal syrup, or other bitters of a vegetable character, is ad- 
rised. If the system has long been suffering from chronic disease, 
this should receive special attention. Every hygienic means should 
be adopted that will improve the general health. 

In erysipelas arising from wounds, the local treatment is of great 
importance, and consists principally in the use of the antiseptics, such 
as carbolic acid, sulphate of zinc and the like. 

Boil. — Ferunculus. 

A wit has termed these troublesome things '* comforters." An ex- 
perience in this line is very likely to enhance our knowledge of Job's 
situation, if not elicit our sympathies. Wherever situated, the place 
is not one to suit our convenience. "We always prefer it somewhere 
else and perhaps on some other person. 

Beginning in a small point in the cellular tissue under the skin, it 
enlarges in every direction, pushing up the skin in the form of a 
pyramid. There is much redness, swelling, heat and pain. The 
skin is tense, red or purplish, hot and shining. In about a week it 
reaches the size of an hazel-nut or wall-nut, shows a white spot or 
head which opens through the skin, discharging bloody matter. 
When the sheath of the abscess called the care is expelled, the flesh 
soon heals. Sometimes, from blood impurities, boils follow each other 
in rapid succession. As painful as they are, they have a value in in- 
dicating a crisis, when under medication designed to expel these im- 
purities. 

TREATMENT. 

Thorouirh rubMng with the hand will sometimes dispel them, or 
applying spirits of camphor while rubbing. Internally may be given 
two drop doses every three hours of tincture of arnica, or teaspoon- 
ful doses of fresh lime water in half -cups of milk three or four times 
daily. If the boil still shows signs of progressing, as soon as the out- 
line is apparent an hypodermic syringe may be pushed into its cen- 



6-2 MEDICAL PRACTICE. 

tre, leaving a drop only of a mixture of equal parts of carbolic acid 
and glycerine. If these means are not at hand the pain may be relieved 
by rubbing, beginning at the outside of the inflamed circle and ap- 
proaching the centre spirally. Or, if the skin is unbroken, apply on 
a disk of flannel or cloth, covered with oil-silk, 

I£. — Tincture of Arnica flowers, 
Tincture of Aconite root, 

Xaudanum, in equal parts. 

Mix. 
Should these means fail, it will be better to poultice with hot water 
compresses, or with flaxseed poultice, or with bread and hot milk 
poultice. This favors decay and softens the skin. "When the whit- 
ened head appears the abscess should be opened, to facilitate the dis- 
charge of the contents and hasten recovery. The ripened point 
should be frozen, either by the application of a piece of ice well 
salted and held in a napkin, or by applying a spray of ether or chloro- 
form to the part. When the skin becomes whitened it is insensible 
and the lance or penknife blade should at once be introduced. No 
after-dressing is necessary but water or the antiseptic ointment. 

Abscess. 

In some particulars this resembles a large boil. There has been 
an inflammatory condition in the part affected, with heat, pain and 
swelling. The result of this inflammation is the discharge of degen- 
erated matter or pus. This process is called suppuration. This 
pus becomes located, is encased in a false membrane and points, like 
a boil, in the direction of the least resistance. This process may re- 
quire a week or it may take months. In low grades of fever and in 
the debilitated, an abscess may be accompanied with all the symp- 
toms of grave disease. There may be feeble pulse, hot skin, coated 
tongue, loss of appetite, with chills, night sweats and hectic. 
Abscesses form in all parts of the body; in the breasts, neck, arm- 
pit and groin; in the different organs, particularly iu the lungs, liver, 
kidneys and tonsils; about the rectum, the hip joint and spinal 



MALIGNANT BOIL. 653 

column. Fluctuation can usually be felt and when the tumor 1 
closely approaches the surface can be seen. They may be opened as 
soon as pulsation is detected, the same as boils, or the operation may 
be delayed, until, by hot compresses, they point. The matter (pus) 
should be completely discharged by gentle pressure and the cavity 
freely washed out by injecting a mixture of one part of carbolic acid 
and twenty of warm water. This washing should be repeated daily 
until pus ceases to flow, when a compress wet in the solution may 
be applied and pressure exerted by a bandage, when healing will 
rapidly take place 

Psoas or Lumbar Abscess forms near the spine and may involve 
the bones in the destructive inflammation. It appears in the scrofu- 
lous or may result from injury to the back. The notable feature is 
that the pus follows the large muscles which gives it its name, and ap 
pears for exit upon the front of the body, in the groin. Swelling 
from the accumulation continues at this place until vent is made. 
The abscess should be opened promptly, and the parts thoroughly 
washed with the carbolic acid solution just mentioned. A flexible 
catheter should be introduced and passed along the muscles and 
through this the wash carried to the spine. The loss of flesh and 
strength are great, and the suffering is sometimes distressing. The 
curvature of the spine is distorted when these bones are involved to 
any great extent. Constitutional treatment is necessary, and often 
the only one admissible. This consists mainly of the Compound 
Queen's Root syrup, and alteratives noticed in writing on scrofula 
and in the use of the Cod Liver oil and Hypophosphites mentioned 
in the treatment of consumption. 

Malignant Boil.— Anthrax, Carbunculus malignus. 

Anthrax is an infectious disease transmitted to man and other ani- 
mals from diseased cattle. It comes from contact with the flesh or 
blood of the carcase, or through the agencies of flies. The following 
will illustrate its virulence. The skin of an ox, which died of an- 



654 MEDICAL PRACTICE. 

thrax, in the fall of 1852, was in the following spring soaked in a 
pond and then made up by a saddler into harness. The saddler 
had carbuncle. Of a flock of sheep that was washed in the pond 
four weeks later, twenty perished in a few days of anthrax and both 
of the horses for which the harness was made, after four day's use, 
showed symptoms of the disease and died in forty-eight hours. A 
speck like a flea bite first appears upon some uncovered part of the 
body. This burns and itches, soon forms a blister and bursts, dis- 
closing a dark red base. This crusts over, but the redness and swell- 
ing continue until they cover the entire arm, half the neck, etc. 
The p:irt is hard, doughy and slightly suppurative or gangrenous. 
High fever, delirium and collapse follow. 

TREATMENT. 

The bleb should be excised and part of the surrounding healthy 
flesh, or carbolic acid in crystals should be freely applied. Internally 
two drop doses of the acid in a dram of glycerine every hour and 
stimulants. The use of the Turkish bath is indispensable. Recov- 
ery is slow at best. In some cases one or two years are required for 
complete restoration and before the usual health and strength are 
regained. 

Carbuncle. 

This is a malignant tumor closely resembling a large boil. It is 
situated upon the back of the body, its favorite seat being the nape 
of the neck. It begins in a pustule which burrows in all directions 
from this point as a centre and extends until it attains a size of from 
three to six inches in diameter. Flat, hard, immovable, burning and 
painful, it reaches its full dimensions in about ten days, when small 
blisters appear upon different parts of its surface. This will open and 
discharge a thin bloody and fetid pus. Its malignancy is now apparent. 
The skin which was dark red or purplish now mortifies and sloughs off, 



FELONS. 655 

leaving a large open ulcer, extremely offensive in odor and appear- 
ance. Sometimes the skin is not much damaged but the tissue under- 
neath has extensively mortified. Chills, fever and great prostration 
of strength attend carbuncle. 

TREATMENT. 

This must be active and every effort must be made to save tissue 
and limit the inflammation. At the outset glycerine and veratrum vi- 
ride, equal parts, should be continually applied by compress. Verat- 
rum in two drop doses should be administered internally every two 
hours. One hoar after each dose the sulphite of soda in three to five 
grain doses should be given. This intern al treatment should be kept 
up as long as the disease continues, lengthening the intervals be- 
tween doses as the inflammation subsides. The diet should be nour- 
ishing and milk given freely. Suppuration may be hastened by ap- 
plying hot packs. When the openings form in the tumor or are arti- 
ficially made with the knife the topical treatment should be changed 
to antiseptic injections. As often as four times a day each one of 
these should be thoroughly syringed with a solution of carbolic acid 
one part and warm water five parts. The pain caused by the caus- 
tic soon subsides. Threads of lint soaked in the solution should be 
pushed with a probe into the openings and a double thickness of lint, 
soaked in the same, laid over the carbuncle and frequently renewed. 
The deep cavity left fills up slowly but the antiseptic dressings should 
be employed uninterruptedly until the surface heals. 

Runrotjnd, Felon, Whitlow. — Paronychia. 

A kind of boil or abscess upon the fingers, but commonly met 
upon the hands, arms or toes. When superficial or burrowing around 
the root of the nail it is called run-round. A bandage saturated with 
veratrum viride or a strong solution of carbolic acid, will cure this 
form. When located in the flesh or beneath the covering of the 
bone it is very painful, the surface is red and swollen, and there is a 
deep-seated throbbing, increased by holding the hand down. Sleep 



656 MEDICAL PRACTICE. 

is broken, and, in fact, often impossible, unless the hand is fastened 
above the head by a sling secured to the bed-post or head-board, or 
some such means. When the felon opens the pain ceases. Attempts 
should be made to thwart this tedious process. There are several 
plans for so doing. One is to lake fresh poke root, bruise it, and heat 
upon the stove. When hot, envelop the finger and tie over it a piece of 
oil-silk. Another is to soak the finger in strong lye water, warm. Still 
better, soak in strong carbolic acid solution and paint over with 
collodion, with several coatings, allowing one to dry before making 
another. This contracts with even pressure. If these fail, the ab- 
scess should be opened with the blade of a penknife. This opera- 
tion is painless if the finger is first rendered insensible with the spray 
of chloroform or ether. In fact, a freezing mixture, such as snow 
and salt, will cure a felon. Put the finger in the mixture and hold it 
there till the pain ceases. It may increase at first, but persevere. 
Kepeat if the pain returns. 

Corns. — Claims. 

These are round, small, horn-like excrescences upon the body pro- 
jecting above the surrounding skin. The papillae of the skin (little 
points filled with nerves and blood-vessel>), from some external or in- 
ternal irritation, take on uncommon growth. The scarf skin also 
develops unduly. Corns appear upon the hands and feet, particu- 
larly the latter, and result from friction or pressure, by too loose or 
too tight boots or shoes. The hard corn is situated on the sole of the 
foot, on the joints of the toes, ami chiefly on the small toe; the soft 
corn, differing in no particular from its neighbor, grows between the 
toes. The softness is due to the continual bathing m the perspira- 
tory vapor. The roots are the vertical fibres, but their extraction 
does not insure against their reappearance. Corn9 seldom more than 
annoy and pain their possessor; the exception being when they in- 
flame from uncleanhness excessive walking or dancing, or cause 
inflammation and decay of the bones and their periosteum. Fashion 



CORNS. 657 

looks with favor upon a small foot, and as the boot or shoe must be 
" one size smaller " than sense and comfort require, it is safe to pre- 
dict that among her votaries the crop of corns will continue to be 
promising and the harvest abundant. 

TREATMENT. 

Prevention is better than cure and this can readily^ be attained by 
removing pressure, daily washing in cold water, and friction. 
When they become irritated and painful, relief can be secured in this 
way: Take a piece of leather and cut a hole sufficiently large so 
that when laid upon the surrounding skin the edges of the corn will 
not touch it. Stitch to this on the side coming next to the skin sev- 
eral thicknesses of canton flannel having a hole in each centre Lke 
the one in the leather. If both surfaces come in contact with the 
skin, as between the toes, the flannel should be sewed to both sides. 
The thickness should be such that the object making the pressure is 
removed beyond the top or crown of the corn. 

A similar plan may be followed in the treatment of bunions. If 
hard, they should first be softened either by the application of oil or 
grease, or by soaking in warm water. When softened, acetic acid, 
pure, just as it is obtained from any drug store, should be applied 
nig it and morning. In a short time the corn loosens and can either 
be removed by pulli g or lifted out by the finger-nails or blade of a 
pen-knife. The scarf skin is to be carefully removed by a sharp 
knife or razor as frequently as possible, taking care not to cut too 
close and cause bleeding. Chiropodists insert a knife point between 
the corn and true skin and cut around the circumference and lift it 
out without pain or loss of blooil. The raised edge protects the sen- 
sitive pit, and a soothing ointment assists in affording comfort, and 
effecting a cure. 

Soft Corns may be relieved by covering with ointment and insert- 
ing a pledget of cotton wool between the toes. This should be 
frequently washed and pared. The compound tincture of iodine 
makes a good application. Another plan is to apply some vesicating 
plaster well charged with cantharides and allow to blister, at the 
28* 



658 MEDICAL PRACTICE. 

same time protecting the opposite surface. In twenty-four hours cut 
away the raised cuticle and apply tannin, or an ointment of tannin 
and lard. This tan. 9 the corn. 

"When the pressure is received over an extensive surface a callous 
condition, callosity, follows. The physiological condition is analo- 
gous to the production of corns. Instances are the palms of the 
hands in laborers, the kne- s of housemaids, the shoulders of carriers, 
and the soles of the feet in children who go hare-footed. Callous ' 
plares are painful when they become hard, thick and dry. Pro- 
longed bathing In hot water, and scraping with a dull knife or filing 
constitute the usual methods of relief. 

"Warts. 

These growths, Which also a'ise from the excessive development 
of the papilh-e of the true skin, need not be described. They cause 
annoyance to the adolescent mind — not from any sc nsation they pro- 
duce, but because of their unplcas mt appearance. Various remedies 
are suggested. It used to be supposed that the application of a piece 
of stolen beef to the growths would dissipate them. There ave evi- 
dent objection-; to this treatment. A better plan is to apply a little 
nitric acid — aqua fortis. This must be done very carefully. Not 
more than one dram (t-aspoonful) should be kept in the house. 
Take a small sharpened stick — a lucifcr match — dip it in the acid, 
and so apply a tiny drop to the top of the wart. It soon becomes 
yellow, and in a few days the top can be picked off. Repeate 1 ap- 
plications in the same way arc nc; essary. Strong acetic acid may 
be used in the same way, first having pared the wart. It is slower 
in its action, but is less liable to burn the llesh, or make it sore. If 
it biles too sharnly immerse the part in water, to dilute the acid. 
Chloride of zinc lint is an efficient remedy. 

Bunions. 

This is a painful swelling of the second joint of the great toe. and 
h produced by pressure by a tight fitting boot or shoe. The bursa is 



FETID FEET. 659 

a small sack, which contains oil for lubricating the joint and tendons, 
and from the unnatural position of the toe takes on inflammation. 
Bunions are sometimes seen upon the small toe or on the instep. 
Pressure may be removed by the use of the cushion described in the 
treatment of corns. When inflamed a foot-bath in hot water and 
rest are necessary. The covering should be light and pliable. The 
bunion should be painted daily with the compound tincture of iodine, 
and this treatment persevered in, for the cure is tedious and difficult . 
under the most favorable circumstances. 

Fetid Feet, Stinking Feet. 

Persons much dislike to associate with the victims of this annoy- 
ance, and to 1 hose of keen scent their society is unbearable. It is 
likely a disease, and not due to habits of uncleanliness, as is often 
hinted and sometimes, perhaps, stated in not the most pleasant tone 
or language. Frequent washing does no good, and if the unfortu- 
nate is at all sensitive, he or she is doomed to much unnecessary 
discomfort. Odorous perspiration of the feet may be a disease of 
the skin, of its glands or dependent upon some disease of the system 
which must first be removed before its cure is possible. 
treatment. 

Woolen stockings only should be worn, and must be changed once 
or twice a day, those taken off to be dried by the tire. The daily 
change of boots or shoes is also advantageous. If this is not practi- 
cable, felt insoles should be worn which can be changed with the 
stockings. Upon removal, they should be wetted in chlorinated 
soda and dried for further use. Daily (and twice a day is better) the 
feet should be soaked for some time in tannin and warm water or 
pinus canadensis and warm water. For those living in the country 
near a tannery a half pailful of tan liquor will answer the purpose 
If always heated before use. The antiseptic ointment mixed with 
carbolic acid makes a good dressing. 



6G0 MEDICAL PRACTICE. 

Incurved or Ingrowing Toe-Nails. 

This troublesome and painful affection is caused by pressure by the 
boot or shoe, by which the nail becomes thickened, rolled in a horn- 
shape, and enters the flesh. The inflammation extends under the 
nail and suppuration may follow. 

A notch, like the letter V, should be cut in the center of the end 
of the toe-nail. The nail should be scraped with the pen-knife down 
its centre until it is very thin, leaving either side its customary thick- 
ness. The notching and scraping must be repeated every few days. 
If possible, the inserted portion cutting the flesh should be raised 
and a little piece of raw cotton inserte 1 under it to prevent it from 
returning. Previous to insertion this may be wet in a solution of the 
persulphate of iron. Thus raising the edges the nail is flattened and 
the iron heals any ulceration that may be present. Some prefer the 
insertion of rubber sheeting, very thin, and in very small pieces, which 
protects the flesh from the cutting edne better than the cotton lint. 
These instructions, faithfully followed, will relieve most cases. 
Sometimes, however, it is necessary to administer chh roform and 
remove the whole nail by slipping under it the sharp thin blade of a 
penknife or a surgeon's scalpel. 

Gall, Chafe \nd Chap. 

These condition- arise from moisture, and the latter from moisture 
and cohl. Parts wetted with perspiration or writer, rubbing together, 
or friction by the clothing, produces chafe. Tender and delicate skin, 
particularly in children, and that between rolls of fat, are most 
affected. Smearing with the nntiseptic ointment, find protection from 
the irritating garment, is all that is required for its removal. 

Chapped hands, lips or nipples, is an annoyance experi' need by 
those in whom the parts are subjected to moisture and exposed to 
cold wind, or weather, or to friction. Glycerine should be thoroughly 
applied and well rubbed in. The hands should be warn ly covered 
with wool gloves. Cold cream may be used upon the lips. Tannin 



FROST-BITE. 661 

may be added to the glycerine in coating the nipple. The antisep- 
tic ointment will answer for all. 

Frost-Bite. 

From exposure either of long or short duration, according to the 
intensity of the cold, different parts of the body, particularly the nose, 
ears, fingers and toes, are liable to become frozen. In one of the Arc- 
tic exploring expeditions, a man removing his glove to chop wood, 
had four fingers frozen in two minutes. The operation in this 
climate is more tardy and affects out-door laborers or drivers, and in- 
sufficiently protected children. The first sensation is that of cold 
and pain with bluish color of the skin and is soon followed by white 
or bloodless cast, and insensibility. The part should, as soon as dis- 
covered, be rubbed with snow or ice-water, the friction being followed 
up until there are positive signs of an active circulation, warmth, red- 
ness and pliability. Warm rooms and the fire are to be shunned, for a 
too sudden change of temperature may result in death of the affect- 
ed member. 

Freezing to death is analogous and attended with the fame 
symptoms increased in proportion to the extent involved. Here, 
however, there is difficulty of breathing, and an almost uncontrollable 
desire to sleep. If this is gratified, death is the inevitable result. 
Every effort should be made by the party affected and by his attend- 
ants to re-establish the circulation of blood. If riding in a " biting 
air," upon th< i first approach of numbness run by the side of the 
sleigh, or, allowing Ihe horse to go free, hold on behind and run for a 
mile or two — country miles at that. Upon finding a person sleeping 
and freezing, remove the bo ly to a cool room, divest him of cloth- 
ing and rub with snow or cold water, flex the limbs, institute artifi- 
cial respiration the sime as in death from drowning, and when con- 
sciousness returns walk the person, continually flapping the body 
with the palm of the hand. When partly revived, stimulants maybe 
administered and the per on clothed warmly. Keep away from 



662 MEDICAL PRACTICE. 

heated rooms and fires. Persons partly or wholly intoxicated are 
more liable to " freeze to death " than others; besides, they have less 
force of will to overcome the tendency to sleep. 

Chilblains differ but little if any from frost-bites. Both are 
caused by exposure to cold. Chilblains are more likely to be chron- 
ic, and affect more particularly scrofulous constitutions. The heels, 
tlie fingers and toes, are the parts most predisposed. The pain is not 
constant, but rather pungent and shooting at particular times and an 
insupportable itching attends. If the exposure has been long cm- 
tinned, the inflammation may be severe, and the surface mortify, leav- 
ing an ulcer. Frozen parts sometimes remain for years sensitive to 
cold and wet w T eather, and from their diminished vitality, the com- 
plaint recurs with greater facility. 

Treatment. — Prevention consists of the use of warm clothing 
and exercising care when exposed to inclement weather. When 
the surface is unbroken apply the liniment 

3. — Tr. Aconite root, 

Tr. Arnica flowers, 

Laudanum, . . . .in equal parts. 

Mix. 
Or 

1$. — Sulphurous acid, . . • one ounce, 

Glycerine, .... one-half ounce, 

Water, one ounce. 

Mix. 
Apply night and morning. A strong tincture of capsicum, freely 
applied once or twice a day, is good treatment. 

This kind of treatment is only proper in case the chilblain is un- 
broken and is intended to increase circulation and nutrition. If it 
blisters, discharges or ulcerates, it should be treated as an ulcer. Ob- 
stinate cases are occasionally met with which no local application 
will remedy until some disordered state of the system is removed or 
the general condition of the patient's health improved. 



OTHER SURFACE INJURIES. 663 

Burns and Scalds. 

A slight superficial burn is best treat- d by covering the part with 
any thickish fluid or gum that will exclude the air; for instance, 
molasses, glycerine, warm glue, linseed, olive or castor-oil and var- 
nish. Blisters should be pricked, and the scarf skin gently smoothed 
down and some simple ointment or oil smeared over it so that the 
dressing will not stick to it when removed, The burn may now be 
covered with cotton-wadding and a bandage used to keep it in place. 
A healing amplication is made of olive or linseed oil, three or four 
ounces, and carbolic acid, ten to thirty drops. This is poured upon 
the skin above the wound and permitted to run down between the cot- 
ton and the skin, thereby moistening both, bathing the injured surface, 
removing foul odors, lessening the discharge and promoting healing. 
Common whiting, mixed with water to the consistence of thick 
cream, and smoothly spread upon linen to the thickness of one-eighth 
of an inch, makes a go< d and soothing application. It must be kept 
moist by occasional sprinkling with warm water. 

A piece <>f charcoal, laid on a small burn, at once extracts the 
pain, and if k-pt applied for a half hour, cures completely. Bicar- 
bonate of soda, common cooking soda well powdered, may be 
sprinkled on a seal i or burn, and over this a wet compress placed. 
The compress must be kept moist with water or a solution of the soda 
in water. It relieves pain promptly and permanently. 

The white of an egg is good, in fact, almost anything that will ex- 
clude air. We think some one of the many articles mentioned will 
be found in every household. We prefer the oil and carbolic acid, or 
glycerine and carbolic acid, followed in case of suppuration or deep 
sores, by the use of an antiseptic ointment. All liquids should be 
applied with a soft brush, and usually the sooner the application is 
made the less liability to blister. Cotton wadding makes an excel- 
lent dressing; is soft and excludes air. A burn is more serious than* 
a scald and it is more likely to prove serious on the chest and body . 
than on the limbs. The danger to life lies not so much in its severity 



664 MEDICAL PRACTICE. 

as in its extent, and the amount of shock produced upon the ner- 
vous system. If the application does not remove the pain give 
opium or even chloroform. It is worse than useless to administer 
alcoholic beverages; they only do harm. 

When the burns are serious, as in cases where the cl thes take fire, 
great care must be taken not to remove the skin, which has but little 
hold upon the flesh, and is quite likely to be somewhat firmly attached 
to the clothing. If it sticks never so little, leave thfe sticking piece 
in its place and cut away the remainder. It is a go< d plan in every 
instance of extensive burn or scald, not to a; tempt to remove the 
clothes, but carefully cut them up, particularly those garments next 
the flesh. Thoroughly sponge the piece with the saturated solution 
of baking soda, until it easily lets go. Oil may be used for the same 
purpose. After the ointment and cotton are applied the patient may 
be wrapped in sheets and blankets. 

The clothes catching fire, whether by accident or by carelessness, 
is a sad and deplorable disaster. The natural and ungovernable im- 
pulse seems to be to run for help instead of to help one's self. The 
individual should immediately lie down upon the floor and roll 
toward water, or, what is far better, woolens, either clothing, mat- 
ting, or bed-covers. Wrapping in t:iese completely excludes the air 
and the fire is extinguished. Call for assistance if you will, but do 
not run for it. Many lives might be saved by this means, and it re- 
quires but a moment's thought. The friends or neighbors have 
usually to do the ihinking, however. They should throw down the 
sufferer, and cover with whatever woolen is most handy ; the head and 
shoulders first. Envelop the body completely for one or two minutes 
and then apply V a remedes. 

By ballet-dancers, and others exposed to fire, precautionary meas- 
ures must be adopted. The clothing is rendered incombustible by 
wetting in one part of the neutral solution of tungstate of soda and 
five parts of soft water. This destroys neither the texture or color, 
and positively renders the fabric incombustible. 



BURNS AND SCALDS. 665 

Kerosene Lamp Explosions. 

Some persons seem to think that the explosion of a kerosene lamp 
is caused in the same way as a boiler explosion, viz.: by the pressure 
of the vapor of the oil inside the lamp. In rare instances explosions 
may be caused in this way : for example, where the ignited oil over- 
flows the lamp and ihe lamp is enveloped in flame. But explosions 
usually occur in another way, viz. : where the vapor of kerosene is 
mixed in proper proportions w ith air, and thus a true explosive mix- 
ture is formed, which will < xplode with the force of a gunshot when 
fired by a flame. This explains why a lamp is in more danger of ex- 
ploding when only partially filled with kerosene, because a larger 
amount of space is filled with the explosive mixture; it is the same 
as a large load of powder in a gun. 

Many persons suppose that there can be no danger of a lamp ex- 
plosion unless the whole body of the oil in the lamp is heated to the 
flashing point; that because the temperature of our rooms never 
rises to 120°, there can be no danger in usingoil whose flashing point 
is 120°. But Dr. Baker, of the Michigan Board of Health, has 
proved by experiments with lamps, that an explosive mixture may 
form, and the lamp may explode, while the body of oil in the lamp is 
not above 85 Q F. The temperature of the body of oil in the lamp 
is not the only factor to be considered, because different parts of the 
lamp may become very unequally heated. If you touch the brass 
collar of a lamp which has*been burning for some time, you will find 
it quite hot, an J the tube supporting the wick is still more strongly 
heated. The formation of vapor will be determined by the hottest 
part of the lamp which comes in contact with the oil. "When the 
combustion is imperfect, from any cause, the brass fittings of the 
lamp become excessively heated. Dr. Baker found in his experi- 
ments, that when the chimney was removed and the lamp continued 
to burn, the temperature of the brass collar rose very rapidly in. every 
instance ; in one case, in fourteen minutes, it rose to 161° F. In this 
last instance very rapid explosions occurred by the side of the wick, 



666 MEDICAL PRACTICE. 

and to prevent the whole lamp from exploding the light was ex- 
tinguished. In none of these experiments did the temperature of 
the body of the oil rise above 85° F. Many persons on leaving a 
room will "turn down the lamp" to save oil, but such economy is 
very liable to cause a lamp explosion, which is anything but economi- 
cal. If a light is not needed in a room, either extinguish the lamp or 
leave it burning with the usual blaze. 

Bruises. 

To bruises and other injuries by which the blood accumulates un- 
der the skin, apply plenty of hot water and pressure until all discol- 
oration has departed. Those parts of the surface which are very 
spongy are more easily infiltrated and are with greater difficulty re- 
stored to the natural color. The flesh immediately surrounding the 
eye is of this character. Notwithstanding the disadvantage in posi- 
tion, the hot water treatment should be continued for some time. 
"When completely discolored, cold water, snow or ice may be used. 
This will prevent the further flow of blood into the tissues, subdue 
inflammation, and quickly heal. 



CORPULENCY. 667 



CLASS VI. DEVELOPMENTAL DISEASES. 



DISEASES OF NUTRITION. 



Corpulency, Obesity. 

The accumulation of fat in superfluity is a disease. It attends in- 
dolence, and excessive eating and drinking, though not always. Some 
seem predisposed to rotundity; may be Iran until puberty or mater- 
nity, then develop rapidly. On the other hand plump babies may, 
in later life possess, Cassius-like, " the lean and hungry look." The 
boy or girl of fifteen years who plays violently, rests little, sleeps 
little, is likely to be scant of flesh, while the one who is less active 
in pastimes, naps when all is quiet, likes the bed, tats and digests 
well, may become corpulent. By the clo>e observation of adults we 
have come to the conclusion that obe>ity is greatly influenced by the 
amount of fluids taken and by the state of the mind. The phleg- 
matic Germans are great bier drinkers and are obese. In very m:my 
cases we have found that the rapidly growing drink much water. 
"We are not so sure about less drinking obtaining with less flesh, 
or that free imbibition will generate fat. A friend active, irritable 
and passionate, was attacked with a heart difficulty. Strict rest and 
quiet was enjoined for some six months. During this period the 
habits and condition of mind were remoulded. He became quiet, was 
hard to annoy, and. as a consequence, trained weight rap'dly. Per- 
sons of settled income, the recipients of generous annuities and the 
wealthy, usually are, or grow to be fleshy. 

TREATMENT 

Dio Lewis, in his excellent work on Digestion, addressing a patient, 
advises reduction in the quantity of food brought about gradually, 



668 MEDICAL PRACTICE 

almost total abstinence of drink and exercise to profuse perspiration 
two or three times a day. He adds, "you must not sleep too much. 
Long sleep fattens. Don't go to bed very eirly, but get up very early 
in the morning. Seven hours in the twenty-four, or say six hours i 
for awhile, will do. In other words, my prescription is, keep your 
eyes open and your mouth shut." He believes the Banting system, 
which we will shortly present, generates disease. To talk to a 
fat woman about a brisk walE of a mile daily, is to waste breath. 
Athletes to reduce fat and cultivate muscle labor assiduously. They 
dress in heavy woolens and with frequent mile-runs effect their pur- 
pose. Copious perspiration will not do all, diet mu-t be regarded. 
We were accustomed to see a German, with commendable zeal and 
perseverance, doa" two mile spurt " alternate evenings, varying the 
amusement (?) with a row of five or ten miles on the river. But he 
must have his lager bier and a jug of the cool liquid was always in the 
bottom of the boat. After six month's labor the decrease in weight 
was hardly perceptible. A marine plant (Fucus Vesiculosis) has 
been much used of late as an anti-fat remedy. It is not new aud was 
recommended by M. Duparc. The effect is due to the iodide of 
potash it contains. This potash salt has been used for the same pur- 
pose and is more pleasant. "We were told of a gentleman who took 
the plant for a month, paying no attention to diet, without benefit; 
the month following he dispensed with the drug and conformed 
carefully to the directions for diet, with favorable results. "We know 
of no royal road to lightness and comfort. 

Mr. Banting, an Englishman of great weight, after trying other 
methods, settled upon a plan of his own by which he lost forty-six 
pounds a year. It consisted principally in avoiding bread, butter, 
milk, sugar, beer and potatoes. It is now termed in literature Bant- 
ing's system or Bantingism. "We present it as a curiosity, believing 
there are other and better ways. 

Breakfast. Four or five ounces of beef, mutton, kidneys, broiled 
fish or cold meat of any kind except pork, one ounce of toast, a lit- 
tle biscuit, and a large cup of tea (without sugar or milk.) 



ABDOMINAL SUPPORTERS. 



Dinner. Five or six ounces of any fish except salmon, any meat 
except pork, any vegetable except potato, one ounce of dry toast, 
fruit out of a pudding, any kind of poultry or game, and two or 
three glasses of claret, sherry or Madeira. Champagne, port and 
beer, forbidden. 

Tea. Two or three ounces of fruit, a rusk or two, and a cup of 
tea (without milk or sugar.) 

Supper. Three or four ounces of meat or fish similar to dinner, 
and a glass or two of claret. 




IEMALK ABDOMINAL, 8DPPORTEB. 



670 MEDICAL PRACTICE. 

Debility, General Debility, Weakness. 

A man in his full strength maj', by excessive or long-continued 
exertion, become debilitated, but this is temporary only and not that 
condition referred to by physicians. In this latter there is loss of 
tone of the nervous or muscular systems, and eventually, of 
both. Beginning from many causes some symptoms are in common ; 
languor, indisposition to muscular effort, and, at a later stage, ina- 
bility. The flesh becomes weak and flabby, the skin pale and most 
of the functions of the body impaired. General debility is attend- 
ant upon constitutional or local diseases and is always an index of 
some marked change in, or profound impression upon, the vitality. 
Sometimes typhoid fever will be so slight and so concealed that de- 
bility is about the only symptom. The more active the debility and 
the longer continued, the greater the difficulty in restoring the sys- 
tem to its proper standard; in fact, there is a point beyond which it 
is impossible to rally. It is not so easy to mark the limit in any 
given case, not but that we can gunge the amount of vitality, but there 
is another factor of which we know less, the stock of vital tenacity. 
The disappearance of the robust from our daily walks and observa- 
tions and the living on and on of the invalid " at the point of 
death " far beyond all expectations, has come with wonderful force 
to every one's experience. Vital tenacity comes from several sources, 
from parentage that is long-lived, from health and the absence 
of excitement, worry and physical overstrain during early life. We 
believe it can be cultivated, but not to any great extent. General 
debility, while it saps our strength and vitality, may not draw 
heavily upon our hold upon life. 

Bow-Legs and Knock-Knees. 

An eminent physician of Manchester, England, who has made a 
study of the care of infants, gives some information of great import- 
ance to mothers, in regard to the cause of the common deformities 
known as bow-legs and knock-knees. He attributes the first men- 



BOW-LEGS AND KNOCK-KNEES. 



671 



tioned distortion to a habit some youngsters delight in, of rubbing 
the sole of one foot against that of the other — some, as is well known, 
will go to sleep with the soles pressed together. They appear to 
enjoy the contact only when the feet are naked, not attempting to 
make it when they are socked or slippered. 

The remedy, therefore, is simply to keep the child's soles covered. 
Knock-knees the doctor ascribes to a different childish habit, namely, 
1 that of sleeping on the side, with one knee tucked into the hollow 
behind the other — a custom familiar to the observation of most 
parents. Here the preventive prescribed is to pad the inside of the 
knees, so as to keep tbem apart, and let the limbs grow freely the 
normal way. 




Fig. l. 



Fig. 2. 



Fig. 3. 



Fig. 1. Apparatus for bow-legs, making pressure upon the curve ; single barred. 
Pig. 2. Apparatus for kuock-knee. 

Fig. 3. Apparatus for bow-legs, giving support to the body and making pressure 
upon the curve ; double barred. 



673 MEDICAL PRACTICE. 



CLASS VIL SURGICAL DISEASES. 



Wounds. 

The simplest form of a wound is a cut made with a sharp instru- 
ment. The parts can be replaced and will fit each other exactly. 
But when the object or instrument doing injury is blunt or rough- 
edged, the skin is torn or lacerated and the continuity of surface can 
only be approximated ; cannot be exactly adapted. This does not 
bleed as freely as a cut but has its greater danger in the occurrence 
of hemorrhage at a later period, and when unexpected. 

Treatment. — Much depends upon the character and amount of 
hemorrhage, the part involved and the location. If the blood spurts 
from a wound an artery has been severed. This must be tied or if the 
cut is not too extensive it may be closed and pressure used to stop 
the bleeding. If some time is to elapse before an attempt is made 
to apply treatment, as for instance, in waiting for a surgeon, better 
bind the limb on the side of the cut next the heart, increasing the 
pressure of the ligature until the spurting is perceptibly lessened. 
Another method is by flexing the limbs. If the foot is injured, a 
handkerchief or other cloth made into a pad can be placed under the 
knee, the calf brought to the thigh, and the thigh to the body. This 
cuts off the circulation to the foot to a great extent. In the case of 
the hand or forearm, the forearm should be bent upon the upper 
arm, the roll inserted into the arm-pit and the upper arm held 
closely to the side of the body. The local treatment is by astringents, 
such as powdered alum, burnt cork, tannin, or persulphate of iron, 



WOUNDS. 673 

either in solution or in powder. If the artery is large it must be 
ti> d. Find it in the wound, grasp with a forceps, and while some 




one holds the instrument tie with silk or thread, or if possible with 
carbolized cat-gut. The latter may be clipped short to the knot and 
left in the wound ; the others cause suppuration and must come out 
before the opening will completely heal. Do not include the nerve 
which accompanies the artery or you will have trouble, and lockjaw 
perhaps. In a cut in which no arteries are severed or only small 
ones, bring the edges together, and secure with adhesive strips. The 
adaptation is simplified if the strip is first well secured on one side: 
the edges are then pushed together and when in place let the strip 
catch and hold the other side. If the skin is badly torn or partly 
lost or destroyed, the edges, after removing all foreign substances 
like dirt, sand, hair, clots, etc., should be drawn together by stitches. 
Silver wire makes the best, but silk n ay be used. Remember that 
the closer the edges approach, or if they are trimmed with scissors, to 
prevent irregu'arities, the less prominent the scar. Antiseptic dress- 
ings as below described for ulcers complete the treatment. 

If there are no antiseptic (""ressings, use strips of dry cloth, fitting 
snugly and make the blood itself exclude the air. If the parts are 
carefully brought together and well secured this is all sufficient. Do 
not disturb for a week, then remove after soaking in warm water un- 
til the strips unwind without using force. This treatment is especi- 
ally adnpted to mashed or crushed fingers or toes. 

Stabs, punctures and penetrating wounds are injuries with doubt- 
ful and uncertain terminations. A bayonet has passed through the 
chest and the wound healed ; a tack pricking the finger has caused 
lockjaw. In this and in fact in all injuries, pain does not help us 
forecast the result. The wound may be slight and the pain severe or 






674 MEDICAL PRACTICE. 

it may be insignificant and the injury fatal. Remove foreign sub- 
stances and clean the wound. Inset t in the opening a tuft of horse- 
hair or oakum for .draining and to prevent the skin from healing be- 
fore the internal pans. Cover with a cloth wet in carbolic ac'd and 
water or cold water or with c -tton batting or boracic lint. Each ex- 
cludes the air; the fir.-t and last are antiseptic. The body should be 
occasionally placed in a position to favor the discharge of matter and 
the dressings be frequently renewed. Gunshot wounds may be 
treated in the same manner. In searching for a bullet care must be 
taken not to injure surrounding parts. Very many carry shot in 
their flesh without much inconvenience. The excessive dosing with 
opium and morphine on such occasions is reprehensible. 

The blow of a hammer upon the finger forms what is called a con- 
tused wou' d. The skin appears uninjured but the parts beneath suf- 
fer and are sometimes reduced to a " jelly." Pain attends but is less 
severe as the contusion is more extensive. Plunge the part in hot 
water or apply a hot compress. Continue the heat for a long time. 
If imtter accumulates treat as an abscess. Blood-blisters and water- 
blisters may be opened by a necdl introduced into the neighboring 
skin and carrie.l along under the scarf-skin to the fluid. This takes 
off pressure and relieves pain. 

Bed-sores, Old-sores, Ulcers, Festers. 

These occur chiefly in the debilitated, intemperate and scrofulous. 
The surface may be destroyed to an unlimited extent and not unfre- 
quently the deeper tis-ues decay. Beginning in a small sore, the 
tendency is to enlarge; unlike a wound which inclines to heal. 

Treatment consists chiefly in the use of antiseptics and the ex- 
clusion of air wiih its poisonous vegetable and parasitical germs. 
Ulcers which under the best care formerly consumed a twelve-month 
are now cured in a single month or less time. The good results fol- 
lowing the use of dry earth pointed to the present methods. After 
the earth came the earth and an antiseptic ointment. The use of 
earth was then discarded and antiseptics exclusively employed. We 



ULCERS. 675 

have had flattering effects from a course of treatment in this man- 
ner: Make an application by a brush or by a pad of a strong solution 
of carbolic acid and water. It will not do to use any but the softest 
lint or old linen. We consider a sponge harsh, always using a long 
hair soft brush. The brush we cleanse thoroughly in hot water, ad- 
ding a few drops of carbolic acid after each use. In twenty-four 
hours wash with the brush or by pouring a gentle stream from a height 
of a weak solution of the same. Now apply a compress saturated 
with 

I£. — Carbolic acid, .... one dram and a half, 
Glycerine, ... . . one ounce, 

Water, seven ounces. 

Mix. 

Support must be given to the edges so as to avoid a tendency t o 
pull apart with every motion of the body. Take strips of adhesive 
plaster four inches longer than the diameter of the sore. After shav- 
ing off all hair likely to be touched, apply two and one-half inches 
on one side, taking a direction toward the centre of the s *re, and 
hold until fastened. Now bring the opposite edges that come under 
the strip a considerable distance toward each other, carry over the 
compress and fasten the free end. Apply a second strip in the same 
way across the centre of the first. Over these tie a covering of cot- 
ton batting to exclude the air. Keep the compress wet by pouring 
the lotion upon it. The batting may be frequently removed for this 
purpose but do not disturb the compress of tener than twice daily. Rest 
is also necessary. 

The latest and quickest cure is by boracic lint. To this we refer- 
red in sneaking of lacerated wounds. Surgeons lint or cotton wad- 
ding is prepared by soaking in a saturated solution of boracic acid 
while boiling. This is hung up to dry without pressure. As it cools 
the acid appears in the form of crystals. (Boracic cotton is now an 
article of trade and is inexpensive). The sore and the skin around 
is washed with a solution of carbolic acid or boracic acid and covered 
with a piece of oil-silk the size of the sore and wet in the same. 






676 MEDICAL PRACTICE. 

Three thicknesses of the lint, or one of the wadding, are also wet and 
applied over it. A snug fitting: bandage completes the dressing. 
The rapidity with which large surfaces heal under this dressing is 
almost incredible. 

Varicose Ulcer. — The veins of the leg have considerable weight to 
hear, equal in fact to a column of wa'.er the size of a blood vessel, 
and in length to the distance between the f- el and the heart. Circu- 
lation in the veins is always tardy in th s locality, and any obstruc- 
tion causes swelling or varicose veins and other difficul ies, and results 
in ulceration. It is apparent that bands and garters seriously com- 
plicate matters This may be obvi itcd by fattening ihe top of ihe 
stocking to an elastic which is secured to the corset or waist-band ot 
the pants, both of which should be in turn supported by the shoul- 
ders. When a garter must be v orn it should bind above the knee 
so as to get the benefit of the hamstring U ndons which will in a 
measure kee;> the pressure from the veins. Such ulcers are common 
and should be treated by removing pressure, by resting the limb 
upon a chair while sitting, and upon a pillow while in bed, and by the 
boracic lint as just described. 

Fracture 

Or a break in a bone may be simple, in which case it is divided, or 
it may be divided and one or both erds project through the surface, 
or it may be broken into several pieces, and the flesh, nerves, and 
blood-vessels implicated. Hence the treatment vnries, but the fun- 
damental principles are the same. Bones unite differently from flesh 
and it may be well to contrast them. When the flesh is severed by 
accident or otherwise, the chief aim of the surgeon is to form imme- 
diate union or as it is technically called union by "first intention." 
This i*; more easily accomplished during the first twelve hours than 
at any later period; not that complete rnron will actually occur but 
that it will to a considerable extent and even this advantage is only 
possible within the time specified. The healing cement which nature 
provides is supplied promptly; after awhile the action of the atmoa- 



DISLOCATION. 677 

pherc and its poisonous contents not only cause the discharge of 
poisonous and irritating matter (pus) but tend to chemical change, to 
putrefaction. To obtain the desired result, cleanliness is indispensa- 
ble. No wound or flap should be closed until all particles of bone, 
sand, dust, hair, thread?, lint and even clots of blood are removed. 
It is sometimes tedious to remove all the sand, but this must be care- 
fully and thoroughly done. The wound is dried and the edges 
brought into exact contact, secured by adhesive strips, and covered 
by cotton batting which is glazed on one side and soft and fleecy on 
the other, to exclude the air. The plastic material that is to unite 
the e:ids of bones appears much more tardily, but has its limiting 
time of supply. This will vary according to the part injured, and the 
constitution of the patient, but may be fixed at forty-eight hours. 
Within this period the fragments if displaced should be restored to 
their proper places and there maintained by splints Complete rest 
is necessary for from ten to fifteen ciays, when slight motion is per- 
missible. Not only are the pieces glued together, but an excess of 
bony material has been thrown out about the fracture, forming a 
solid and supporting ring which remains for a year. If the bones 
have been improperly set the deformity remains for life. Splints 
may be made of wood but we prefer those made of wet pasteboard, 
or of clo h wet in starch paste or thin glue, or plaster of paris. 
The part is covered with cotton-batting and one of these applied 
and allowed to diy; a second or third maybe overlayed until the 
support is sufficient. 

A bone may become dislocated by external injury. It is not broken 
but put out of joint with its fellow. Occasionally we have cases 
in which this occurs from disease of the joint The bone must be re- 
placed and held there by bandages and the inflammation and other 
complications that may arise be properly met. 

Scars follow most wounds, their ''ugliness" depending upon the 
extent of skin lost, or the carelessness in adapting the edges. Un- 
less painful or crippling they amount to nothing except upon the 
hands, neck and face where they are easily seen and repel one by 



678 MEDICAL PRACTICE. 

their hideousness and unsightliness. The everted eyelid, deprc ssion 
upon the cheek, lost tip or wing of the no.=e, wryneck and webbed 
fingers from burns, and in fact most all such disfigurements can be 
removed by the surgeon. Autoplastic surger}', with its skin-graft- 
ing and transplanting is one of the wonders and successes of this 
century. 

Stitches are rheumatic pains in the side, closely resembling pleurisy. 
They are sharp and sudden and may be increased by pressure, breath- 
ing and motion. Doctors call it 'pleurodynia. It is not always in the 
chest walls, but may be caused by wind in the intestines, and is lo- 
cated in this viscus under the short ribs. In this ca-e aromatics are 
indicated; in the other, rest and hot packs, or the hot water bag. 

Strains can hardly be called injurious, for we strain upon making any 
extra muscular effort. It becomes painful and dangerous when we 
overstrain. This is the popular meaning of the word strain. The 
muscular fibres are stretched beyond their power to return. Rest is 
required until nature repairs the injury. 

Sprains. A sprain is a violent wrenching or twisting of the fibrous 
parts of a joint. The wrist, knee and ankle are most often sprained. 
This is followed by inflammation, slight or extensive, according to 
the amount of injury. Their history presents some strange incident*. 
A lady, after a month's care of a sprained ankle, was walking wilh 
difficulty and care, when slipping, her whole weight came upon the 
injured foot. The partial displacement was remedied and all pain 
departed. A lady skating sprained both ankle and knee and was 
unable to walk. Cold compresses were used and in twenty-four hours 
she could walk. A gymnast sprained his wrist in " tumbling;" the 
pain was slight, but a low grade of inflammation continued for a 
long time, and it is doubtful if the wrist ever recovers its former 
strength. A lady accidentally stepped upon a thin sheet of ice, not 
m f ot square, frozen to the sidewalk. Her ankle turned, but she. 
was able to walk to her home close by. It was four months before 
she left her bed, and nearly a year before she walked without limp- 
ing. It is evident that no accurate prognosis can be given in case of 



PROUD FLESH. 679 

sprain. It is a great misfortune at any time. The treatment consists 
of absolute rest, and the application of a lotion consisting of 
1£. — Tincture of Aconite root, 
Tincture of Arnica flowers, 
Laudanum, . . .in equal parts. 

Mix. 
This may "be applied by a compress wrapped around the joint. 
Lightning Stroke is usually fatal. When there are evidences of 
life, however feeble, use friction, dashes of cold water and artificial 
respiration, as advised under suspended animation. In a thunder- 
storm better keep away from lofty trees, metal structures, and other 
good conductors of electricity. Lightning rods are a protection if 
properly constructed, but the majority throughout the country are 
worthless, if not dangerous. 

Diseased Conditions Following "Wounds. 

Upon the surface of wounds, whether surgical or accidental, false 
growths sometimes appear. In familiar language it is known as 
Proud Flesh, by surgeons as Fungotity. The treatment is by caus- 
tics; it is easily destroyed by blue vitriol, al hough some cases re- 
quire sulphate of zinc or carbolic acid, and, in obstinate cases, chlor- 
ide of zinc. 

Ganouene is the partial death of a part or organ. It is the dread 
of the hospital, civil or military. It sometimes acts as a contagion, 
attacking all open wounds; or it may be caused in an individual case 
by violent inflammation, by frost or burning, or by any means that 
cuts off the circulation of blood to the part. There is loss of sensa- 
tion in the part affected, the surface is mottled black, blue and pur- 
plish, and covered with water blisters. Every effort must be made to 
reduce the inflammation and internal means be employed to neutralize 
and expel the blood poisoning. If the part turns black, mortification 
has set in and the treatment should then be directed toward prevent- 
ing its spread. This is done by the application of the sulphate of 
zinc, which sloughs off the decayed mass. 



680 MEDICAL PRACTICE. 

Caries and Necrosis. The bones are subject to the same devitaliz- 
ing processes as the flesh. Caries of the bone is analogous to gan- 
grene of the flesh, and necrosis to mortification; the former is decay, 
the latter death. Caries occurs from injuries, poisons and the pro- 
gress of certain constitutional diseases, specific and scrofulous. There 
is a hard and extensive swelling of the bone and soft parts, abscesses 
form and the matter burrows through the flesh, forming cana's which 
eventually ' ; point" upon the surface. Through these is discharged 
dark-colored, f e i 1 and bloody matter, copious in quantity and hav- 
ing a peculiar odor. Hectic fever is common. A probe pa-sed into 
one of these openings will detect the rough surface of the bone. This 
is characteristic, for bone covered with its proper membrane is always 
sinooth. Hip disease is a scrofulous caiies of the hip joint, resulting 
in a shortene 1 leg if not in more serious consequences. Caries may be 
stopped by reducing inflammation and if there is an opening, by in- 
jecting sulphate of zinc, chlorate of potash and the like. If the bone 
is dead, it will be impossible to he ;1 the openings and the necrosed 
bone must be removed by the surgeon. 

Pyaemia. "We will close t'd.s subject by a few remarks upon py- 
aemia Here the veins inflame and either form pus and throw it in- 
to ihe circulation or they absorb ihe decaying matt* r and thus effect 
poisoning of the blood. There is a severe chill, followed by profuse 
sweating, nausea and vomiting, tongue badly coated, offensive breath 
anl dejections, dark colored and fetid urine i;nd tenderness of the 
whole body. Then follows painful abscesses and delirium; and 
coma precedes a fatal termination. The treatment consists in freely 
opening all the abscesses and injecting them with carbolic acid or 
sulphate of zinc solutions, and in using internally the tincture of iron 
and quinia or other antiseptics and tonics. 



LONGEVITY. 681 

Concluding Chapter. 

"The more slowly man grows," says Professor Hufeland, "the 
later he attains to maturity and the longer his powers are in expand- 
ing, so much longer will be the duration of his life ; as the existence 
of a creature is lengthened in proportion to the time required for 
expansion. Everything, therefore, that hastens vital consumption, 
shortens life ; and, consequently, the more intense the vital action, the 
shorter the life. If you would live long, live moderately, and avoid 
a stimulating, heating diet, such as a great deal of fish, flesh, eggs, 
chocolate, wine and spices." Animal food, and all other stimulating 
diet, particularly in youth, do incalculable mischief, though by such 
slow degrees, that in general the evil is neither perceived nor suspected. 
Th<j stream of life is hurrh d on precipitately, the passions are pre- 
maturely developed, and, like a plant that has been forced too rap- 
idly by artificial heat and stimulating composts the organism is ex- 
hausted, and it becomes diseased and old when it would, under a 
more appropriate diet, have been in its perfection. 

"It has been established on the best grounds, that our nourishment 
should be used in form rather coarse, securing full mastication and 
insalivation, and a longer retention in the stomach. Plain, simple 
food only, promotes moderation and longevity, while compounded 
and luxurious food shortens life. The most extraordinary instances 
of longevity are to be found among those classes of mankind who, 
amidst bodily labor and the open air, lead a simple life, agreeable to 
nature, such as farmers, gardeners, hunters, etc. The more man 
follows nature, and is obedient to her laws, the longer will he live ; 
the further lie deviates from these the shorter will be his existence. 
Rich and nourishing food and an immoderate use of flesh, do not 
prolong life. Instances of the greatest longevity are to be found 
among men who, from their youth, lived principally on vegetables, 
an 1 who, perhaps, n<rver tas ed flesh." "It seems," says Lord 
Bacon in his Treatise on Life and Death, "to be approved by expe- 
rience that a spare and almost Pythagorean diet, such as is prescribed 
29* 



682 MEDICAL PRACTICE. 

by the strictest monastic life, cr practised by hermits, is most favor- 
able to long life." 

The Pythagoreans, who lived on a simple vegetable diet, afforded 
the most numerous instances of old age. " The Essenes, as we call a 
sect of ours," says the Jewish historian Josephus, " live the same 
kind of life as those whom the Greeks call Pythagoreans. They are 
long-lived also, insomuch that many of them live above a hundred 
years by means of their simplicity of diet and the regular course of 
their lives." 

• It is said that in no part of the world (in proportion to its popula- 
tion) are there more instances of extreme longevity than among the 
Norwegian peasantry, who scarcely ever taste animal food. In the 
severe climate of Russia also, where the inhabitants live on a coarse 
vegetable diet, there area great many instances of advanced age. 
The late returns of the Greek church population of the Russian 
empire give (in the table of the deaths of the male sex,) more than 
one thousand above one hundred years of age, many between one 
hundred and a hundred and forty, and four between one hundred 
and forty and one hundred and fifty. It is stated that to whatever 
age the Mexican Indians live, they never become grey -haired. They 
are represented as peaceable cultivators of the soil, subsisting con- 
stantly on vegetable food, often attaining a hundred years of age, yet 
still green and vigorous. Of the South American Indians, Ulloa 
says : "I myself have known several who, at the age of a hundred, 
were still very robust and active, which unquestionably must, in 
some measure, be attributed to the constant sameness and simplicity 
of their food." Both the Peruvian Indians and the Creoles are re- 
markahly long-lived, and retain their faculties and vigor to a very 
advanced age. Slaves in the West Indit s are recorded from one 
hundred and thirty to one hundred and fifty years of age. 

"We cannot bring the argument to a scientific demonstration unless 
we could compare vegetable feeders with the feeders on animal food, 
in regard to longevity, with all the other circumstances the same. 
Nevertheless, it is clear that eminent physiologists and able and im- 



SUDDEN DEATH. 683 

partial inquirers have been impressed with the belief that vegetable 
diet tends to longevity. Flesh-eaters — nay, intemperate eaters and 
drinkers — are sometimes long-lived; but we are justified in saying 
they would have lived longer still on a wiser diet. 

RULES FOR LONG LIFE. 

In brief, the requisites for longevity, may be secured 

By a good physical organization. 

By proper training; of the appetite; of the passions, especially by 
fatherly and motherly instruction at the age of puberty. 

By regularity in all things ; exercise, sleep, bathing, etc. 

By avoiding excesses, bad habits, bad company. 

By dismissing care and worriment. "When the office closes leave 
all anxiety and business troubles in the safe. Business, at best, is 
but an experiment. Cultivate the habit of doing business cheer- 
fully. Care ploughs deep furrows in the face. 

By securing before advanced life an annuity. 

'By gentle recreation, agreeable companionship, and innocent 
amusement. 

By avoiding cities. If you must do business in town, live in the 
suburbs. 

By plenty of undisturbed sleep. < 

By plain and unadulterated food and pure water. 

Sudden Death. 

Most people have a dread of sudden death, and yet this is the 
death of old age and seems to be the most natural. Sitting in a chair, 
the head of the aged person falls forward upon the chest and the 
"light has gone out." The popular opinion prevails that sudden 
death is due to heart disease, but the facts do not warrant such con- 
clusions, at least in the majority of cases. Post-mortem examina- 
tions are not as frequent in this country as in Europe, and it is from 
this source that we have the statistics of sixty-six cases of sudden 
death, in each one of which post-mortems were held. These exhi- 
bits show that of this number only three died of heart disease, nine 



684 MEDICAL PRACTICE. 

were of apoplexy, and forty-six of congestion of the lungs. In other 
words, the most frequent cause of sudden death is the filling of the 
air-cells of the lungs with blood or the water (serum) of the blood. 
Sometimes this can be remedied. In collapse, for instance, or great 
prostration, when it seems to be too late to give stimulants by the 
mouth or rectum and where death seems certain, inject alcohol or 
whisky under the skin by the hypodermic syringe. Instantly the 
heart feels the stimulus, the pulse comes up, the lungs are more 
active, heat returns to the surface, and the lusterless eyes gleam again 
with the light of life. 

Evidences of Death. 

We stated in the first pages of this volume that persons are often 
buried alive. The results of the researches instigated by the French 
government prove as much. In catalepsy, the pulse, the heart- 
beat, and the circulation of blood, are imperceptible. There are 
other conditions of the system which closely resemble death. Many 
tests have been devised, but we will mention but two which are com- 
mendable for their simplicity. One is to submit the finger or toe to 
the flame of a candle ; if a blister forms the person is alive, for this 
function is an evidence of a vital process. Another method is to 
wind a cord around the finger or toe an inch or two from its end. 
If the part beyond the ligiture swells (congests), it is an evidence of 
the fact that the blood still circulates and hence that the person is 
still living. 

Painless Death. 

We will close this part of the volume with a few extracts from the 
pen of Prof. A. Wilder. 

"To grow old gracefully his been indicated to be one of the 
greatest moral achievements of a cultivated mind. It involves heroic 
qualities to part with youth, and whatever of beauty and enjoyment 
are associated with it, and adopt the costume of mature life — a fur- 
rowed countenance, a paler or du-kier complexion, thin and silvery 
hair, dimming sight and increased sensitiveness to the several agen- 



PAINLESS DEATH. 685 

cies which co-operate to pull down 'tlds earthly tabernacle.' We 
sadden almost imperceptibly ; the vivid zest of pleasure is snper- 
seded by the calmer enjoyment of repose ; our selfish propensities 
concentrate into avarice ; our retiring passions leave greater space 
for affections and the sober virtues. 

"The terror of dyin? is perhaps the greatest which we suffer. We 
would gladly bargain with fate for any amount of privation and en- 
during torture to secure exemption from the necessity. We become 
gloomy at the thought or mention of the dreaded occurrence. A 
light word upon any topic related to it is regarded with a species of 
horror. 

"Nevertheless, however sacred the instinct of life, it is the law of 
nature and in the providence of God, that we shall die. Every plant 
and animal that ever existed, however remotely in geological time, 
was born, lived and died, by divine law, inherent in all functional 
existence. The races of men are no exception. Accepting the event 
of death as ordered by the same law as th.it which caused our exist- 
ence to begin, the motive that impelled the establishing of both con- 
ditions must be alike Godlike, and equally benevolent and beatific. 
It is best for us, most fortunate for us, that having properly accom- 
plished our careers, we die. 

" Sudden death, without premonition, now so common, is a boon 
rather than a hardship. If we have ' set our house in order,' at- 
tended lo all persons and matters requiring our care, and have not 
inopportunely hurried our end, there is abundant reason to welcome 
such a conclusion. It seem=; to us a glorious thing to live our life 
out full, exhausting its powers without disease, and then cease to 
exist from the sudden stopping of the machinery. If destiny, which 
overrules our acts and purposes, lias that end in store for us, we 
would in advance declare it the mode most agreeable. 

"It is evident that persons liable to trance are likely to escape cor- 
poreal life painl ssly, as a bird leaves a cage, or a traveler his inn. 
Persons sometimes die from having no desire or energy of will to 
live. The individual of healthy body who has avoided disease and 
unwholesome habits, goes to death as to asleep, from which for once 



686 MEDICAL PRACTICE. 

he fails to awake. It is more like the insensibility from chloroform 
than a breaking up of the physical economy. The stroke of light- 
ning, the blow of the ax, and the instan'aneous crushing of the 
brain, end life at once, without a pang. The terror constitutes the 
entire suffering. Those who die in syncope, if they have any sen- 
sation, experience one that is rather pleasurable than otherwise. 

" Most diseases remove the source of p;un as they approach amor- 
tal issue. The 'agonies of death' are but struggles or writhings, 
in which there is no suffering whatever. There are muscles which 
are moved or kept in quiescence by the influence of the will upon 
them. At the period of death, and sometimes on other occasions, 
this influence is withdrawn : upon which they quiver and exhibit 
appearances that unsophisticated spectators mistake for suffering. 
A bird with its head cut off struggles in the same manner. Those 
who die of fevers and most other diseases experience their greatest 
pain, as a general thing, hours, or even days, before they expire. 
The sensibility of the nervous system becomes gradually diminished, 
the pain is less acute under the same exciting cause ; and so far from 
being in their greatest d ; stress when their friends imagine it, their 
disease is acting upon their nerves like an opiate. Many times, in- 
deed, they are dead, so far as respects themselves, when the bystand- 
ers are more to be pitied because of the anguish which they endure 
from sympathy. 

" If we look this matter of dying in the face, so to speak, as criti- 
cally and calmly as we consider other topics, we can escape a world 
of apprehension, alarm and misery. We are perishing every moment, 
so far as the molecules of our bodies are concerned ; the textures 
are constantly giving way, and even oxygen, the vital air, takes the 
life from whatever it touches and sets it to decaying. Yet. this never 
alarms ; the crisis or culmination is what we regard as the serious 
matter. 

"There are three modes of dying, from syncope, asphyxia and 
coma. The latter is the suspension of the functions of sensibility, 
by operating on the brain. The long-continued action of cold, re- 
acting like opium and chloroform, lesions of the brain as by fever 



PAINLESS DEATH. 687 

or apoplexy, occasions this condition. There is little or no sensa- 
tion. Asphyxia, or suffocation, occurs from suspension of respira- 
tion, or the access of oxygen to the blood. At first the heart receives 
venous blood into its left side and transmits it over the body. This 
operates on the brain, suspending sensation : the medulla is para- 
lyzed and with it the pneumogastric nerve ; the lungs refuse to trans- 
mit non-oxygenated blood, and the heart and other vessels cease 
action. Drowning, strangulation and poisonous gases produce this 
condition. Syncope proceeds from the interruption of the circula- 
tion of the blood and may occur through hemorrhage, weakness, or 
paralysis of the walls of the heart, as from the use of tobacco, or 
from injuries to the nervous system, as from concussion or shock, 
or from violent blows, lesions, violent mental emotions, a stroke of 
lightning, exposure to the sun, or from poisons. 

lt Our purpose is to show that death generally occurs when we are 
asleep or unconscious, and so comes upon us insensibly, like repose 
upon a weary man. Nature strives to render us indifferent or de- 
sirous of the end. While life is really precious, she intensifies the 
desire to live ; but as its uses are accomplished, she makes us willing 
to leave. To the well-ordered mind it is evident that death is as 
fortunate an event for us as any that occurs. 

"As most of us do not accept the declaration of Winwood Reade 
and his fellow-philosophers, that "the belief in immortality must 
die," but instead look for a continuous existence, it must appear 
obvious to us that our mundane li r e is a kind of preparatory school 
for the next. It certainly is not well to hasten thither till we grad- 
uate ; yet when the time arrives there is every reason for passing to 
the next st ige gladly and fearing nothing. By living morally and 
physiologically we shall escape the pain so much dreaded ; by con- 
sidering the ma'ter calmly and reasonably, we will annihilate the 
terror ; by faith in the loving and the right, we shall apprehend all 
the grent facts and know that we pass from the good to that which 
is better." 



MEDICAL PRACTICE. 



MEDICAL APPLIANCES. 



New Spring Pad Truss. 

(TUCKER'S.) 

A Perfect Appliance for the Relief of Hernia. 

The "New Spring Pad Truss" has been devised for the purpose 
of giving permanent relief to all who are afflicted with abdominal 
hernia in any of its forms. It is a new and important invention for 
the relief of rupture, and if properly adjusted it will invariably re- 
tain the hernia, and give great comfort to the patient. 




As compared with the old style body spring appliances, it is ac- 
knowledged by the most skilled surgeons in the country as being far 
superior. 

The "New Spring Pad Truss" is held to its place securely by a 
belt of fine non-elastic webbing, and so completely and comfortably 



TRUSS FOR HERNIA. 689 

is the hernia retained, that the wearer is in a short time unconscious 
of its presence. 

We offer this appliance, confidently believing that it possesses 
points superior to any other. The main features to which we desire 
to call particular attention are : 

First. — The fact that it absolutely holds the hernia with greater 
ease to the patient than any other. 

Second. — Its ready and complete adjustability, by which each pad 
is made either right or left at once, and fixed at any desired angle. 
" Third. — The ►> shaped spring, by which a constant but easy up- 
ward pressure is given to the pad when adjusted. 

Fourth. — There is no body-spring to gall and rust ; there are no 
elastic bands to wear out. 

Fifth. — It is exceedingly durable, and is more economical at the 
price than the ordinary Spring Trusses would be at 50 cents each. 

Directions for Applying the Single Truss. — After placing the 
pad over the opening, see that the top plate is adjusted in a perpen- 
dicular position. This enables the belts to draw at right angles. 
The adjustment is made by loosening the large screw at the top and 
fixing the spur in the proper hole, then tighten the screw and adjust 
the belt. 

For applying the Double Spring Pad Truss. The angle of the pad is 
determined by the small screw which passes from the connecting 
bar into the extension of the lower plate. 

The distance between the pacls is varied by removing the small 
screws in the connecting bar, and after loosening the large top 
screws the pads can be moved either up or down obliquely, which 
has the effect of increasing or lessening the spread of the pads. 
After tightening the large screws and fixing the angle of the pad by 
the small screws the truss is ready to be applied. 

When in double hernia the openings are not on a Yne, it ma)' be 
necessary to have one pad a little lower than the other. This is done 
by removing the small screw in the side to be lowered, and after 



690 MEDICAL PRACTICE. 

loosening the large top screw slide the pad down, then adjust the 
screws. 

Springs — Care should be taken that the springs should be of 
proper tension; no stronger than necessary to retain the rupture. 

Extra springs are furnished at a nominal cost, and are easily 
changed by the patient. 

Belts. — The belts are of durable non-elastic webbing, those for 
single trusses being provided with one perineal strap, and those for 
double trusses with two. 

Always apply the truss with broad part of pad down ward. 



Portland Respiratory Brace— (Patented 1877.) 
(To be suspended from above.) 




Fig. 1. 



RESPIRATORY BRACE. 



691 



This brace is especially designed for the relief of those who are un- 
able to lie down on account of difficulty of breathing, as in asthma; 
a grateful support in cases of spinal diseases; an indescribable re- 
lief to those oppressed for breath from heart or lung diseases, 
dropsy, etc. 

It makes it possible for the physician to emvloy anodyne reme- 
dies, which are otherwise contraindicated by the difficult breathing 
in the horizontal position. 

The brace enables the sufferer to 
sleep with perfect comfort in an up- 
right position, and in an attitude 
most favorable for efficient respira- 
tion. It is indispensable to conva- 
lescents too weak as yet to support 
themselves, affording a refreshing 
change of posture, and counteract- 
ing stagnation of blood in the back 
of the lungs in cases of prolonged 
sickness ; at the same time enabling 
the nurse to rub the patient's back 
or dress a bed-sore. 

It is a great luxury to those who 
travel on the cars by night, and may 
be readily attached to the rack 
above the seats in ordinary railway 
cars. 

Directions. — In difficult breathing, as in asthma, the brace should 
be applied as in Fig. 1. The patient will breathe with much greater 
ease sitting up in a chair than in bed. A swivel-chair is preferable, 
and au inflated rubber chair cushion will be an indescribable com- 
fort if the sitting be prolonged. For mere support to procure sleep, 
as when riding in the cars by night, or for an after-dinner nap, the 
elbows should be slipped into the loops, as in Fig. 2 




Fig. 3. 



692 MEDICAL PRACTICE. 

Electrical Machines. 

Electricity, as an adjunctive means of treatment, is very valuable. 
A physician's office is incomplete without a battery. Its value is 
only determined by its proper me. To simply request a patient to 




OFFICE OB FAMILY MACHINE— TEN CURRENTS. 

purchase and use a battery, without giving specific instructions for 
its employment, is a custom followed with doubtful results, if not 
actual harm. We do not, however, by any means consider it a 



ELECTRICAL MACHINE. 693 

panacea; for, like other remedies, sometimes it succeeds admirably, 
and at others fails absolutely. It has its place and its sphere of use- 
fulness, both of which 'will undoubtedly enlarge as the science of 
electro-therapeutics advances. The cases are few in which it can be 
solely relied upon, as in neuralgia, aphonia, menorrhagia, etc., but 
with proper medication its assistance may be called upon in all de- 
rangements of the nervous system, particularly in neuralgia, paraly- 
sis (except in brain lesions), exhaustion from overworked brain, 




TIP BATTERY — ALWAYS READY FOR USE. 

hysteria, chorea, and aphonia. Its tonic properties are worth em- 
ploying in the treatment of amenorrhea, dysmenorrhcea, menorrha- 
gia, rheumatic headache, swollen joints, torpid liver and bowels, 
dyspepsia, incontinence of urine, and prolapsus of the womb. In 
such cases the descending current is advised. The negative pole is 
applied to the feet, and the positive current passes through the hand 
of the patient or the physician while stroking or rubbing the surface 
of the body above. The contrary, or ascending current, in which 



694 MEDICAL PRACTICE. 

the positive pole is applied to the feet, produces muscular contrac- 
tion, and stimulates the nerves. This treatment is advantageous in 
local paralysis, stiff joints, and the like. In neuralgia, rheumatism, 
and paralytic affections, authors advise the alternation of the Fara- 
diac current and galvanization. In several instances, electricity has 
dispersed tumors. In all cases it must be used regularly, but for a 
short time at each sitting, and continued for several days and per- 
haps weeks. 

Belts. — We are often asked our opinion of electric belts. From 
lack of personal experience, we have none to give. Patients report 
that they have used them, but where improvement occurred during 
their use, it was doubtful if it might not be traced to other causes. 
In many instances they failed completely. It is remarkable that no 
choice is made between an electrical machine, with its different cur- 
rents, and possessing positive powers, and these belts. An hour's 
use of the former will do more good than the latter possibly could 
in a life time. 

DOMESTIC MEDICINES. 

This list comprises t7ie simpler remedies and compounds heretofore men- 
tioned, with a brief description of their properties and uses. 
Cathartics.— The necessity of a remedy to move the bowels is too 
common, too apparent, and too generally understood to need com- 
ment. But it is not so simple a matter to nod one that is unobjec- 
tionable. They are either unpleasant, uncertain in their action, 
purge violently, contain poisons, are painful, irritating, or otherwise 
so depressing as to leave a disagreeable feeling, coated tongue, etc., 
for several days following their use. We recommend magnesia (not 
that of the shops), but Calcined Magnesia, that has been made, 
packed and sealed in vacuo. It is tasteless, has np grit, neutralizes 
acid conditions of the stomach and bowels, and in half-teaspoonful 
doses moves the bowels so gently that it is doubted if a cathartic ac- 
tion has taken place. In teaspoonful doses it is more active. We 



FAMILY REMEDIES. 695 

administer in sweetened milk or water. Its action may be hastened 
by following with a glass of lemonade. In cases where the bowels 
are more torpid, or a more active remedy is desired, we prefer to use 
the Anti-bilious Pills. 

Diuretics. — These agents act upon the kidneys, and stimulating 
these organs, increase the flow of urine, and with it the escape of 
blood impurities. That this effect is often desirable will be in- 
ferred from the preceding pages, in which we have frequently re- 
peated the Nitre Compound. This recipe combines in a pleasant 
and palatable form the favorite diuretics of the three schools of 
medicine. It may be prepared without water, and thus kept for 
any length of time. Three parts of water may be added to one part 
of the mixture, and it is ready for use. 

Expectorants. — The frequency of colds and coughs shows the neces- 
sity of a Cough Syrup as a domestic medicine. We employ the 
compound of lobelia, blood-root, tolu, etc., noticed on another page. 
The dose is a teaspoonful for an adult, which may be lessened ac- 
cording to age. Not only does this loosen the cough, but removes 
congestion of the lungs, and any other derangement that may follow a 
slight cold. It is valuable in hoarseness, wheezing, croup, influenza, 
and bronchial irritation. A tablespoonful is a relaxing emetic. 

Alteratives. — A blood-purifier to be effective must tone up the 
stomach, so that digestion is improved, the bowels and absorbents, 
so that assimilation is perfected, and must so strengthen and call 
into activity the emunatories that all effete and impure matters are 
expelled. "With good blood forming, and impurities continually es- 
caping, we may expect in time the removal of constitutional taint, 
and the return of health and vigor. The composition of the Queen's 
Root Alterative Compound will readily suggest to the physician its 
varied uses. To others we may say that it is indispensable in scrof- 
ula, in scrofulous and specific diseases, and following acute attacks 
of erysipelas, eruptive diseases and fevers, in chronic skin disorders, 
glandular swellings, long standing rheumatism, etc. 



696 MEDICAL PRACTICE. 

Anti-malarial. — In several places in this work we have alluded to 
a pill to be used as a prophylactic to malaria; in other words, a 
remedy to be used by persons living in marshy, low, and malarious 
districts, or in localities affected with epidemics. See pages 245, 372, 
489, and 494. It is much more in accordance with common sense to 
guard against chills and fever, ague, intermittent or remittent fevers, 
or even congestive and yellow fever — not to speak of neuralgia, en- 
larged liver and spli-en — than to run the chances of resorting to the 
doubtful effects of the "pound of cure." Travelers, tourists, yacht- 
men, mariners, and the people generally, use them when they know 
of their existence. We should be very likely to hear of a case of 
failure; but so far have received no adverse report. The Anti-mala- 
rial Pill is recommended as a prophylactic only, or only in the 
earlier stages of attacks, during the first feelings of indisposition. 
It will be observed that it is gently cathartic, and during exposure it 
should be promptly employed to relieve constipation, however slight. 

JRevuh'ives. — A revulsive is an agent which calls the blood to the 
surface, and thus relieves internal parts or organs of congestion. A 
mustard plaster has this effect. Mustard should always be mixed 
with cold water. Hot water prevents the formation of the acid which 
irritates the skin. We seldom use the mustard flour alone, but mix 
with it one-third of ground ginger: its good effects are more last- 
ing. Besides, blistering will destroy the good effects of the paste, and 
not unfrequently have an opposite effect to that intended. Indeed, 
it sometimes aggravates the local trouble. Never allow the paste to 
blister, but when the surface is well reddened, remove and reapply 
when the skin becomes pallid. With children we use the ginger 
only, dispensing with the mustard entirely. A more common form 
of revulsive is a liniment. The Hartshorn Liniment, composed of 
sassafras and olive oils, hartshorn and camphor, is exceedingly valu- 
able. It is recommended specially in quinsy, but may be rubbed on 
by the hand over any part where the skin is not broken to relieve in- 
ternal pains, swellings, or inflammation. 



FAMILY MEDICINES. 697 

Benumber. — The Aconite Liniment lias a still greater field of use- 
fulness. It may be applied upon a flannel disk or pad to any part 
of the surface where the skin is unbroken, or not blistered, to re- 
lieve deep-seated pains, neuralgia, stitches, sprains, nerve irritation, 
etc. A distinction something like this may be made in the use of 
the two : The hartshorn liniment is indicated in cases of internal or 
local swelling; the aconite liniment in cases where the pain is sharp, 
shooting, and the swelling is absent. 

Clwlera Tincture. — This is the summer remedy for choleraic disor- 
ders. It is taken in a little water. It relieves cholera morbus 
promptly. Two or three doses of a teaspoonful, in water, every four 
or six hours will stop diarrhoea. 

Antacid Cordial or Compound. — This cordial, as elsewhere stated 
contains rhubarb, spearmint, etc, It has no cayenne, as in the cholera 
tincture. It is suited to all ages (except infants) and all constitutions. 
It should be employed in looseness of the bowels, diarrhoea, dysen- 
tery, heartburn, several forms of dyspepsia, headache from foul 
stomach, nausea, indigestion, flatulency, acid stomach, pregnancy 
and piles. The dose for an adult is a teaspoonful every one, two, or 
three hours, according to the urgency of the symptoms. It is fre- 
quently alluded to throughout this work. 

Anti-spasmodic. — Brandy and whisky and cayenne pepper are the 
most common stimulants; but the Chloroform and Lavender 
Compound is more prompt, and, we might say, more penetrating. It 
stops fits and convulsions at once. For years we have used this 
recipe, and never have had occasion to want another. It may be 
used in colic, dysmenorrhcea with or without the addition of gel- 
seminum. 

Styptics are agents employed to stop hemorrhage or bleeding. 
They are not applicable to surgical injuries (see Wounds.) The flea- 
bane and cinnamon are invaluable in nose bleed, bleeding from the 
lungs or stomach, in piles, bloody flux, flooding and menorrhagia. 

30 * ' 



698 MEDICAL PRACTICE. 

Hypnotics (uid Anodynes are to produce sleep and relieve pain. 
For the former we employ the Hop Pills, made of lupulin and gel- 
semin ; for the latter, the Opium Pills or the Morphine Pills. We 
seldom use the morphine, relying almost wholly upon opium. Both 
constipate, but the morphine is likely to disturb the stomach the 
next day. These are best in pill form, for the weight is accurate. 

Ointments. — We have noticed but two kinds. The White Oint- 
ment, or, as some call it, the Salt-rheum Ointment, is meant spe- 
cially for skin diseases, granulated eyelids, sore eyes, and in dressing 
malignant wounds and ulcers. 

The Antiseptic Ointment has been frequently recommended, 
and a knowledge of its ingredients will demonstrate the wide range 
of its utility. It is anti-septic, and as it is now a matter settled be 
yond dispute that any open or denuded surface is besieged at once 
by myriads of animal and vegetable growths floating in the atmos- 
phere, which poison the flesh and hasten decomposition, we stop 
this action at the outset. Hence, it can be applied with benefit to 
any cut, burn, scald, blister, sore or ulcer. It is waxy in nature 
and shields the flesh still further from the action of the air. It is 
oily, relieves the tension of the surface in inflammation, and is pene- 
trating; hence its use in boils, felons, sore throat, swellings, sprains, 
overstrain-. It is one of the most healing applications of which we 
are aware, and also contains an anodyne; hence its application to 
chapped lips and hands, piles, fistulas, and, thoroughly rubbed upon 
the surface, will allay internal pains. It is almost inodorous. If it 
has any scent at all, it is of the most delicate and agreeable of all 
perfumes — that of the rose. Thoroughly rubbed in, the oily con 
stituent will not mark the clothing; if by accident it should, it is 
easily and completely removed by washing. 

Gelseminum. — This remedy is simply a relaxant. We use only 
tincture of the green root. Three drops is an average dose. Its 
uses have been pointed out in the foregoing pages. 

Belladonna.— Viz prefer the English tincture. It is the remedy in 



FAMILY MEDICINES. 699 

tendency to and congestion of the head, in scarlet fever, and in all 
disorders with a dry skin and throat, in coma and tendency to stu- 
por. The dose is from t< n to thirty drops in a tumbler of water, 
given in teaspoonf ul doses every hour. The solid extract we prefer 
in headache. It alto makes a good plaster to relieve pain and sur- 
face conges" ion. 

Verairum. — We use the tincture of the green root only. This we 
consider one of the greatest remedies in the whole field of medicine. 
It is a heart regulator, and through it controls fevers and inflamma- 
tions. The average dose is about three drops every two hours until 
the pulse falls to seventy, and then every three or four hours. Re- 
peatedly have we advised it, and in several instances commented 
upon its therapeutical powers and properties. In an overdose it is 
a poison. The best way to give drop doses is in the following man- 
ner: Drop twenty -four drops into a tumbler, pouring from the bottle 
upon a cork and allowing the drops to fall from the cork. Into the 
same tumbler put eight teaspoonfuls of water. It is evident that we 
have eight doses of a teaspoonful each, holding three drops in so- 
lution. Invariably we add the essence of wintergreen, ten or fifteen 
drops, as a flavor and as a stimulant. It is the sheet anchor in pneu- 
monia, fevers, erysipelas, puerperal convulsions, and to abort the 
inflammation following surgical injuries. For further views on this 
subject, the reader is referred to pages 232, 233 and 241. 

Phosphorus and JNttx Vomica Pills. — This is the remedy for the ex- 
hausted brain and nervous system, whether from severe mental 
labor, continued excitement, loss of memory, dizziness, paralysis, 
epilepsy, impotency, neuralgia, vital exhaustion, nervous headache 
or debilitating diseases resulting in loss of nerve force. 

Composition Powders. — This is composed of bitter roots and herbs 
and cayenne pepper. It is an old and reliable remedy, and has been 
used in the form of tea, taken upon retiring, to break up a cold, 
threatened fever, etc. 

Pepsin. — This is the active principle of the gastric juice, and will 



700 MEDICAL PRACTICE. 

digest food outside as well as in the stomach. It is a valuable help 
to the dyspeptic, will relieve indigestion, and cure some forms of 
diarrhoea. 

Pharmacy. 

The great majority of our vegetable extracts are not uniform and 
reliable in their quality and manufacture. Among other causes, 
from the following: 

They are not collected at the right season of the year. 

They are not properly cured. 

There is a great difference in the strength and quality of the arti- 
cle, owing to differences in soil and climate where produced. The 
"Western scull-cap is far superior to the Connecticut growth. 

Using articles that have become inert or worthless through age or 
other causes. 

Chemical changes by light, heat and the atmosphere. 

Want of knowledge in their selection, manipulation and manu- 
facture. 

Vegetable remedies are easily adulterated. 

The profession are unfortunately unable to tell the crude article 
onetime in ten; think it too much trouble to prepare their own 
medicines, and are not sufficiently skilled to test those that they pur- 
chase and know that they are of proper quality and properly com- 
pounded. Patients lose their lives for want of this knowldge by 
their medical advisers. The result is, the physician is often disap- 
pointed in his prescriptions, and the patient loses confidence — even 
hope sometimes — if he does not suspect he is the subject of experi- 
ment. 

A writer to the Druggist reports " the result of examinations of 
eighteen fluid extracts of Belladonna made by different manufac- 
turers. They ranged from 410 to 80, or, in other words, the weakest 
preparation was but one-fifth the strength of the most active. Such 
facts are startling to practitioners. Doubtless similar uncertainty 



PHARMACY. 701 

prevails, though perhaps not to such an extent, in the whole range 
of pharmacal preparations. A remedy for the evil is imperatively 
demanded. The responsibility and remedy rest with the pharma- 
cists. The rapid progress of pharmaceutical science within a few 
years past, and the multiplication of associations and schools for its 
culture, ought to have debarred the possibility of results so embar- 
rassing and disreputable. We are assured that fluid extracts are the 
most certain and uniform of medicinal preparations, and they are 
largely prescribed by physicians under this guarantee. We turn the 
subject over into the hands of our pharmacists for that attention 
and reform which are alike demanded by the magnitude of the sub- 
ject in its relation to life and disease, and by their own reputation 
and their obligations to the community. " 

In another chapter we have given the results of a personal exam- 
ination of some of the simpler drugs, magnesia, &c. But read what 
the American Pharmaceutical Association reports: 

"Mr. C. B. Allair again calls attention to the great quantities of 
spurious ' American Dandelion ' floating about. It is chicory. Ev- 
ery manufacturer has fluid ext. of dandelion on his list, but none 
apparently has any fluid ext. of chicory. Opium containing ten per 
cent, of earthy matter was sent to Prof. Attfield. Wild cherry 
largely adulterated with sassafras bark has been met with by Prof. 
Maisch. Mustard was found to vary all the way from mustard fla- 
vored with flour to flour flavored with mustard. Cardomons are 
mixed with orange seeds and unroasted coffee to the extent of four 
per cent. Fine large ergot is scarce; a great deal of small-sized 
ergot is imported into this country, consisting only in part of ergot 
of rye. Guaiac wood containing its proper proportion of resin 
seems to have almost disappeared from the market. Eleven sam- 
ples were examined, and all except one were devoid of resin. The 
greatest adulteration is practised in powders, principally on account 
of the difficulty of detection. We have been informed that certain 
wholesale drug houses have rooms set apart for mixing powders," etc. 



■ 703 MEDICAL PRACTICE. 

"If we ever expect to reduce the practice of mediciue," says Mr. 
J. U. Lloyd, "to a science of facts, it is necessary to understand 
each disease and its antidote; and as the first step in this direction, it 
is absolutely necessary that physicians be supplied with medicines 
that are invariable and unchangeable. They cannot hope to prac- 
tice with any degree of certainty or satisfaction while medicines of 
different strengths are upon the market, all purporting to be identi- 
cal representations of the active principles of certain crude drugs; 
and just here is where pbarmaceutical chemistry enters the field. 

" Will the pharmacist always make a reliable pharmaceutical from 
the drugs the market is supplied with? Can he be expected to take 
the crude botanical specimens in the market and send from his labo- 
ratory medicines reliable and unvarying, each article representing 
the active principles of the prime crude drug? I think he cannot 
do so ; and to introduce my proof, will ask my physician friends if 
they expect any amount of knowledge will enable mortal man to 
squeeze blood from a turnip? Let the pharmacist be ever so capa- 
ble, he cannot take a pound of worthless crude drugs and produce a 
pint of prime fluid extract. He cannot work roots that have lain 
mouldering and rotting five or ten years in some botanical warehouse 
and obtain from them medicines that can be relied upon. He can- 
not use drugs half destroyed by worms and give physicians the 
counterpart of a medicine that was prepared from fresh, prime 
roots. There is reason in all things, and we could as reasonably ask 
the pharmacist to squeeze the turnip until it drips with vitalized 
blood, as to perform the afore-mentioned impossibilities. 

"It is largely of such stuff as I have mentioned that our medi- 
cines are manufactured. God 7ielp Vie poor pMrmacist. Please un- 
derstand me not to be speaking of the man whose label is on each 
bottle when I say pharmacist, but to the poor fellow out of sight of 
the world, who is compelled to take anything and everything, good, 
bad and indifferent, that chance, man and the devil may put into . 
his hands, and from it make reliable medicines. Let us pity him 



GLASS MEASURES. 



703 



and the poor patient who swallows his stuffs, and heaven will care 
for his employer. " 

The whole thing lies in a nut shell. The druggist and pharma- 
cist make their preparations to sell and the physician who maufac- 
tures his own medicines exercises that care in their selection and 
preparation necessary to produce their appropriate and ultimate effects. 
It is to the impurity and inertness of the materials furnished for pre- 
scriptions that much of the disappointment of physician and friends 
is attributable. 





GRADUATED GLASSES. 



704 MEDICAL PRACTICE. 



A LIST 

OF 

MEDICINES AND APPLIANCES, 

THAT SHOULD BE KEPT IN EVERY HOUSE, 

FOR 

DOMESTIC USE. 



Calcined Magnesia. 

Anti-bilious Pills. 

Nitre Compound. 

Cough Syrup. 

Queen's Root Alterative. 

Anti-malarial Pills. 

Hartshorn Liniment. 

Aconite Liniment. 

Cholera Tincture. 

Antacid Cordial. 

Chloroform and Lavender Compound. 

Styptic Oils (for bleeding.) 

Hop (Lupulin) Pills. 

Opium Pills. 

Morphine Pills. 



MEDICINE CHEST. 705 

White Ointment. 

Antiseptic Ointment. 

Gelseminum. 

Belladonna. 

Veratram. 

Phosphorus and Nux Pills. 

Composition Powders. 



Sulphate of Zinc (for Emetics.) 

Tincture of Muriate of Iron. 

Essence of Wintergreen. 

Family Syringe. 

Rubber Bag. 

Alcohol. 

Medicine Spoon, or Graduated Glass. 

Cage Covers to potent medicines. 

Adhesive Plaster. 

Boracic Lint. 

Forceps. 

To which we might add — 
Portable Turkish Bath. 
Spirit Lamp, and 
Atomizer. 

Estimates will be furnished upon application. In supplying 
from our laboratory we guarantee purity. Special remedies and 
special r ppliances are described at length in writing upon the 
diseases to which they are applicable. 
30* 



INDEX. 



A 

Abdominal Dropsy, . . . 315 
Abdominal Fever, . . .247 
Abdominal Supporters, . . 669 
Abnormal Urine, ... 67 

Abortion, 591 

Abscess, 652 

Abscess, maxillary . . . 403 
Abscess of the Lung, . . . 475 
Absorption, .... 54 

Absorption by the Skin, . . 73 
Accouchement, .... 582 

Acetic Acid Poisoning, . . 284 
Acids, Poisoning by . 284 

Acne, . . . . . . 634 

Aconite Liniment, . . . 697 
Aconite, Poisoning by . ■ 286 
Acute Atrophy of the Liver, . 490 
Acute Catarrh, .... 404 

Acute Rheumatism, . . 306 

Addison's Disease, . . .313 
After-dinner Naps, . . .153 
After-pains, . . . .590 

Ague, 241 

Air, action of upon the blood, . 48 
Air in the chest, . . . 475 

Air-passage, Foreign Substances 

in the 476 

Air, pure, 135 

Albuminuria. .... 522 
Alcohol Disease, . . .295 

Alcohol, Poisoning by . . 2S5 
Alcoholic- vapor sweat, . . 172 
Alkalies, Poisoning by . . 285 

Alopecia, 647 

Alteratives, . . . .695 

Amaurosis, . . . .380 

Amenorrhoea, . . . .599 
American Hellebore, Poisoning 

by 291 

Ammonia Poisoning, . . 2S5 
Anaemia, ...... 312 

Anal Fistula, . . . .515 

Analogy between Lungs and 

Skin? 71 

Anasarca, ..... 314 
Anatomy of the Ear, . . 388 

Anatomy of the Skin, . . 632 
Aneurism, Aortic, . . . 430 
Angina Pectoris, . . .429 
Animal Heat, .... 29 



Animation, suspended, . . 477 
Animation, voluntarily suspend- 



Ankle Sprain, 


678, 697 


Anodynes, 


. 698 


Antacid Cordial, 


. 697 


Anthrax, 


. 653 


Anti-Bilious Pills, 


. 695 


Anti-dust Respirator, 
Anti-flexion of the Womb, 


. 473 


. 606 


Anti-malarial Remedy, 


. 696 


Antimony, Poisoning by . 


. 286 


Antiseptic Ointment, 


. 698 


Anti-spasmodics, 


. 697 


Antiversion of the Womb, 


. 605 


Antrum, Ulceration of the 


. 403 


Anuresis, 


. 534 


Anxiety and Worry, 


. 348, 350 


Aortic Aneurism, 


. 430 


Aphagia, 


. 425 


Aphonia, 


. 443 


Apnoea, .... 


. 477 


Apoplexy, . 


. 345 


Apoplexy of the Lungs, 


. 476 


Apparent Death, Restoration in 479 


Appliances, Domestic, 


. 704 


Appliances, Medical, 


. 688 


Apthae, 


. 407 


Aqua Ammonia Poisoning 


, . 285 


Aqua Fortis Poisoning, 


. 285 


Arsenical Paste Poisoning 


. 286 


Arsenical Soap Poisoning, 


. 286 


Arsenical Walls, 


. 132 


Arsenic, Poisoning by 


. 286 


Arthritis, 


. 311 


Artificial Respiration, 


. 479 


Ascaris Lumbricoides, 


. 300 


Ascaris Vermicularis, 


. 300 


Ascites, 


. 314 


Asiatic Cholera, 


. 271 


Asphyxia, . 


. 477 


Assimilation, 


. 53 


Asthma, 


. 449 


Asthma, Hay 


. 452 


Asthma Thymicum, . 


. 443 


Atelectasis, 


. 475 


Atomizer, 


. 400 


Atrophy of the Liver, 


. 490 


Auditory Nerve, the 


. 100 


Aura Fpileptica, 


. 360 


Averting Disease, 


. 219 



INDEX. 



,the 



14-2 



476 



130 



Backache, . 

Bakers 1 Itch, 

Balbuties, . 

Baldness. 

Bandage Following Labor, 

Banting's System, 

Barbers' Itch, 

Barrenness, 

Batbing, 

Baths, .... 

Battery, Electrical, . 

Beads in the Air-passage, 

Beads in the Ear or Nose, 

Beans in the Air-passage, 

Beans in the Ear or Nose, 

Bedbug Bites, 

Bed Rooms, Ventilation of 

Bed Sores, 674 

Beef Tea, 127 

Bee Stings, 280 

Belladonna, . . . .698 

Belladonna, Poisoning by . 287 
Bell's Palsy, . . . .368 

Belly-ache, 497 

Belts, Electrical, . . .694 

Benumber, 697 

Bichloride of Mercury Poisoning 289 
Bile, Elements of 62 

Biliary Calculi, . . . .493 
Biliary Functions, ... 41 
Bilious Colic, . . . .498 
Bilious Complaints, ... 61 
Bilious Headache, . . .338 
Bilious Fever, . . . .245 
Biliousness, .... 488 

Birth, Premature, . . . 591 

Bite of Dog 274 

Bites of Fleas, Mosquitoes and 

Bedbugs, ... 280 

Bites of Poisonous Snakes, Spi- 
ders, etc., 
Black Heads, 
Black Measles, . 
Black Vomit, 

Bladder, Catarrh of the . 
Bladder Diseases, 
Bladder, Functions of 
Bladder, Inflammation of the 
Bladder, Irritation of tbo 
Bladder, Stone in the 
Blebs, Watery, . 
Bleeding, .... 
Bleeding from Drawing Tooth, 
Blenorrhaea, 
Blister, 

Blood Blisters, . 
Blood, Circulation of 
Blood, Effects of loss of 
Blood, Elements of the 
Blood Flowing to a Part, 



25v» 



520 



563 



Bloodlessness, . . . .312 
Blood, Offices of ... 46 

Blood Poisoning, . . 58, 59 
Blood Purifier, . . . .695 
Bloody Flux, .... 508 
Bloody Urine, . . . .524 

Blue Disease 431 

Blue Jaundice, . . . .431 
Blue Vitriol Poisoning, . . 288 
Boards of Health, . . .205 

Body Lice, 646 

Boil, Malignant . .653 

Boils 651 

Bone, Broken or Dislocated, 676, 677 

Bone Diseases, . . . .627 

Bowel Diseases, . . . 482 

Bowel Disorders, 

Bowels, Excretion by the 

Bowels, Inflammation of the 

Bowels, Looseness of the 

Bowels, Obstructions in the 

Bow-legs, 

Brace, Respiratory, . 

Brain and Spinal Nerves, the 

Brain Diseases, . 

Brain Fever. 

Brain, Functions of the 

Brain, Inflammation of 

Brain Work, 

Brain Workers, Meat for 

Breast Ague, 

Breast Caking, . 

Breast, Gathered or Broken 

Breast Pump, 

Breasts, Diseases of 

Breasts, Inflamed 

Breathing, Difficult . 

Breath, Offensive 

Breath, Short 

Bright's Disease, 

Broken Bone, 

Broken Breast, . 

Bronchitis, 

Bronchocelc, 

Bruises, 

Bubo 

Bunions, 

Burns and Scalds, 

Butter of Antimony Poisoning, 



74 

73 
495 
566 

510 
670 
690 
87 
329 
252, 329 



Calcined Magnesia, . . .694 
Calculus, .... 491,493 
Callosity, 

Calomel, Poisoning by 
Cancer, 

Cancer of the Breast, 
Cancer of the Liver, 
Cancer of the Stomach, 
Cancer of the Womb, 
Cancers and Tumors, Difference 
Between I 



INDEX. 



529, 5 
rs 101, 1 



Canine Madness, 

Canker, 

Canker Rash, 

Cantharid.es, Poisoning by 

Carbolic Acid Poisoning, . 

Carbonate of Potash Poisoning. 

Carbuncle, . 

Carbunculus Malignus, 

Carcinoma, 

Cardialgia, . 

Carditis, 

Care of the Teeth, 

Caries, 

Catalepsy, . 

Cataract, 

Catarrh, Acute . 

Catarrh, Nasal 

Catarrh of the Bladder, 

Catarrh, Rose 

Catarrh, Summer 

Cathartic Medicines, . 

Catheters, . 

Causes of Nervous Disorder 

Causes of Skin Diseases, 

Cephalalgia, 

Cerebellum, 

Cerebral Nerves, 

Cerebro-spinal Meningitis, 

Cerebro-spinal Nerves. 

Cerumen, Hardened 

Chafe, .... 

Chancre, 

Change of Diet, . 

Change of Life, . 

Chap, .... 

Charcoal Fumes, 

Chastity, 

Cheerfulness, 

Cherry-stones in the Ear or 

Chest Bath, . 

Chicken-pox, 

Chilblains, . 

Child Bed Fever, 

Childbirth, . 

Childless, Advice to the 

Chills and Fever, 

Chin Cough, 

Chloasma, . 

Chloride of Zinc Poisoning, 

Chloroform and Lavender 

Sound, 
loroform Poisoning, 
Chlorosis, 
Choke Damp, 
Choking, 
Cholera, 

Cholera Infantum, 
Cholera Morbus, 
Cholera Tincture, 
Chorea, 

Chronic Rheumatism, 
Cinders in the Eye, . 



Corn- 



Circulation of Blood, 

Circumcision, 

Cirrhosis Hepatis, 

Cisterns, 

Citric Acid Poisoning, 

Clap, .... 

Clavus, 

Clavus Headache, 

Clergymen's Sore Throat, 

Clonic Spasms, . 

Clothes on Fire, 

Clothing, 

Coins in the Air-passage, 

Coins in the Throat or Gullet, 

Cold Congestive Fever, 

Colds and Coughs, 

Colic, 

Colica Pictonum, 
Colitis, .... 

Collapse of the Lung, 
Colloid Cancer, . 
Color Blindness, 

Coma 

Comedones, 
Complete Fistula, 
Composition Powders, 
Compress, .... 
Compression of the Brain, 
Concussion of the Brain, 
Confidence, 

Confinement of the Sick, close 
Confluent Small-pox, 
Congestion Defined, 
Congestive Fever, 
Congestive Headache, 
Conjunctivitis, . 
Constipation, 
Constitutional Diseases, 
Consumption, . 
Consumption of the Bowels, . I 
Contagion and Disinfection in 

Typhoid Fever, . . . ! 
Contagion, one source of 
Contagious Typhus Fever, 
Continence, . i 

Contused Wounds, . . . > 
Conversation Tube, . . . \ 
Convulsions, . . ; 

Convulsions during Labor, . i 
Cooking Utensils, Poisoning by 

Lead in 

Copper, Poisoning by . . I 
Cordial, Antacid, . . . < 

Corium, ! 

Cornea, Opacity of 

Cornea, Ulceration of . : 

Corns, i 

Corpulency, .... 

Corrosive Sublimate Poisoning, 

Coryza, 

Costiveness, .... 

Coughs and Colds. . 



75, 230 



43, 510 



710 



Cough Syrup 695 

Coup de Soleil, . . . .334 

Crabs 646 

Critical Period, .... 624 

Cross-eyes, 382 

Croup 441 

Crowding in rooms, halls, etc., 50 
Crowing I>isease, . . . 443 
Crushed Fingers or Toes, . 673 

Crusted Tetter 641 

Curvature of the Spine, . . 628 
Cutaneous Exhalation, . . 71 

Cuts 672 

Cyanide of Potassium Poisoning, 2'.)0 
Cyanopathy, . . . .431 

Cyanosis, 431 

Cystitis, . . ... .527 



Dandruff, ( 

Daymare. . . c 

Deadly Nightshade, Poisoning 

by 5 

Deafness, I 

Death, Evidences of . . . ( 
Death, Painless . ( 

Death, Restoration in Apparent 4 
Death, Sudden . t 

Debilitating Occupations, . I 

Debility, ( 

Decaying Teeth, . k 

Definition of the Elements of 

Disease, . . .75, 

Definitions of Medical Terms, . 
Delirium Tremens, . . .5 

Delivery, { 

Dementia < 

Dental Caries, . >■. 

Dental Neuralgia, . . . \ 

Dentition, i 

Developmental Diseases, . ( 

Diabetes Insipidus, . . . { 
Diabetes Mellitus, . . . { 

Diarrhoea, { 

Diathetic Diseases, . . . '. 



Diet, Change of, . 

Diet for Invalids, 

Dietic Diseases, .... 

Diet, Vegetable, .... 

Different Schools of Medicine, 

Difficult Breathing, . 

Digestion, 

Digestion, Imperfect, 
Dilatation of the Heart, 
Diphtheria, . 

Dipsomania 

Disagreeable Breath, . 
Disease Averted, 
Disease Defined, . 



Disease, Elements of . . 75, 230 
Disease Preventable, . . 112 

Disease Transmitted, . . 220 

Diseases, Female, from Neglect 

in Urinating, .... 68 
Diseases from Abnormal Nervous 

Action, 101 

Diseases from Blood Poison- 
ing, 58, 59 

Diseases from Impure Air, . 51 
Diseases from Impure Blood, . 52 
Diseases of Man, . . . 535 

Diseases of Nutrition, . . 667 

Diseases of Pregnancy, . . 560 
Diseases of the Bladder, . . 521 
Diseases of the Bones & Muscles, 627 
Diseases of the Bowels, . . 4S2 
Diseases of the Brain, . . 329 

Diseases of the Breasts, . . 621 
Diseases of the Ear, . . .388 
Diseases of the Eye, ' . . 377 
Diseases of the Fauces, . . 407 
Diseases of the General Nervous 

System, 329 

Diseases of the Heart, . . 428 
Diseases of the Kidneys, . . 521 
Diseases of the Lungs, , . 434 
Diseases of the Mouth, . . 407 
Diseases of the Nose, . . . 394 
Diseases of the (Esophagus, . 407 
Diseases of the Eectum, . . 514 
Diseases of '. he Skin, , . .632 
Diseases of the Spine, . . 627 

Diseases of the Teeth, . . 408 

Diseases of Woman, . . . 572 
Disfiguring by Wounds, . . 677 
Disinfectants, Directions for use 

of 238 

Disenfection of Scarlet Fever, . 263 
Dislocated Bone, .... 677 
Disorders of the Bowels, . . 74 
Displacement of the Womb, . 605 

Diuretics, 695 

Dizziness, . . . . . 432 
Doctor, the Model . . .201 
Domestic Appliances, . . 704 
Domestic Medicines, . . . 694 
Domestic Medicines, Properties 

and Uses of .... 694 
Domestic, Medicines, a list of . 704 
Doses by Drops. • 699 

Doses, Smaller, .... 204 
Double Pains in Labor, . . 586 

Drainage, 161 

Dreaming, 343 

Dress for Women, . . .157 
Dribbling of Urine, . . . 531 

Drop Doses 699 

Dropped Uvula, .... 417 

Dropsy,. 314 

Dropsy Defined, . , , . 75 
Drowning, . . . . .479 



Drugs, Spurious, .... 750 
Drunkenness, . . . 295, 344 
Drunkenness, Hereditary results 

of '221 

Dumb Ague, . . . • . .241 
Dust in the Eye, . . . .383 
Dwellings, Requisites for . 160 

Dysentery, 508 

Dysmenorrhea, .... 601 
Dyspepsia, ..... 484 
Dyspeptic Headache, . . .337 

Dyspncea, 476 

Dysuria, 530 



Earache, ...... 

Ear, Foreign Substances in the 

Ear, Hardened Wax in 

Ear, Inflammation of the 

Ear, Running 

Ear Trumpets, 

Eat, How to . 

Ecthyma, 

Eczema, . 

Effects of Loss of Blood 

Effects of Turkish Bath 



75, 76, 230 



Eggs, 

Electrical Belts, . 

Electrical Machines, . 

Elements of Bile, 

Elements of Disease, . 

Elements of the Blood, 

Elongated Uvula, 

Embolism, 

Emery in the Eye, 

Emissions, 

Emphysema, 

Encephaloid Cancer, . 

Endocarditis, 

Enlargement of the Heart, 

Ennui, ...... 

Enteric Fever, .... 

Enteritis, 

Enthetic Diseases, 

Enuresis, 

Epidemics, 

Epidemics, How Produced, 109, 

Epidermis, 

Epilepsy, 

Epilepsy, Feigned 
Epilepsy, Hysterical . 

Epistaxis, 

Erysipelas, 

Erythema, ..... 
Ether Poisoning, .... 
Evidences of Death, 
Excessive Menstruation, . 

Excretion, 

Excretion by the Bowels, . 
Exercise for Invalids, 
Exercise, Indoor 



71 

695 
665 
518 
377 



Exercise, Results of 

Exhalation from the Skin, 

Expectorants, . 

Explosion of Kerosene Lamps, 

External Piles, . 

Eye Diseases, . 

Eye, Foreign Bodies in the 

Eyelashes, Ingrowing 

Eyes of Smokers, 

Eyes, Watery . 



Faceache, . .""" . 

Facts Established by Hygiene, 

Fainting, .... 

Falling of the Rectum, 

Falling of the Womb, 

Falling Sickness, . 

False Croup, .... 441, 443 

False Teeth in the Gullet, 

False Teeth in the Throat, 

Farm House, Sickness in the . 

Far Sightedness, .... 

Fatty Degeneration of the Heart, 

Fatty Liver, . . . 

Fear, 

Fear of Hydrophobia, . 

Feces, Impacted .... 

Feet, Fetid, 

Feigned Epilepsy, 

Felon, 

Female Weakness, . 
Femoral Hernia, .... 

Ferunculus, 

Festers, 

Fetid Breath, .... 

Fetid Feet, 

Fever and Ague, .... 

Fevers, 

Fingers, Mashed or Crushed . 
Fire in Clothes, .... 

Fish, 

Fish-bone in the Throat or 

Gullet, 422, 

Fissura ani, . . 

Fissure, 

Fistula, 

Fistula in ano, .... 

Fits, 

Fits, Inward . : . . . 
Fits, Nine-day 

Flatulency, 

Flatulent Colic, .... 

Flea Bites, 

Fleas, to destroy . . . . 
Flesh as Food, .... 
Flexions of the Womb, 
Flooding in Abortion, 
Flooding in Labor, 
Flour, Refined .... 
Flux, 



712 



Fly Powder, Poisoning by 

Food Elements, 

Food for Invalids, 

Food, Proper 

Foot Path. 

Force of Will, 

Foreign Bodies in the Eye, . 383 

Foreign Bodies in the Gullet, . 426 

Foreign Substances in the Ear, 392 

Foreign Substances in the Nose, 392 

Foreign Substances in the 

Trachea, ... .476 
Foreign Substances in the Wind- 
pipe, 476 

Foul Breath 40S 

Fowler's Solution, Poisoning by 286 

Fracture ."676 

Freckles, 645 

Freezing to Death, . . 661 

Frenzy, 329 

Frost-bite, 661 

Fruit, 125 

Fumigation 241 

Function of Nerve-centres, . 79 

Function of the Bile. ... 41 

Functions of the Brain, . . 92 

Functions of the Kidneys, . . 64 

Functions of the Skin, ... 69 

Funerals, 159 

Fungosity, 679 

G 

Gall, 660 

Gall-stones 491 

Galloping Consumption, . . 459 

Gangrene, 679 

Gangrene of the Lung, . . 475 
Gastric Cancer, . . . ,486 
Gastric Ulcer, .... 486 

Gastritis, 482 

Gathered Breast, .... 622 
Gelseminum, .... 698 

Gelseminum Poisoning, . . 288 
General Debility, . . . .670 
Gennetic Diseases, . . 535, 572 

Giddiness, 432 

Ginger Plaster, .... 696 

GinLiver, 490 

Glass Measures, . . . .703 

Gleet, 566 

Clobus Hystericus, . . . 362 

Glossary 16 

(Godfrey's Cordial, Poisoning by 290 

Goitre, 294 

Goneness, 486 

Gonorrhoea, .... 563 

Gonorrhoeal Rheumatism, . 307 

Gout, 311 

Gouty Headache, ... 338 

Graduated Glasses, . . . 703 
Granular Lids, . . . .379 



Granular Liver, . . . .490 

Gravel 491 

Green Sickness, .... 313 
Griping, , 497 

Grocers 1 Itch, . . . .639 

Grubs, . .. 544, 634 

Gullet, Foreign Substances in 

the 422, 426 

Gullet, Inflammation cf . . 425 
Gullet. Stricture of the . . 428 

Gumboil, 411 

Gums, Spongy .... 408 
Gunshot Wounds, . . .674 
Gymnasium, Parlor, . . 144 

H 

Habit of Opium Eating, 

Hacking Cough, 

Haematemesis, . 

Hematocele, 

Heematuria, 

Haemoptysis, 

Hair, the 

Hanging, Accidental 

Hardened Wax, 

Hartshorn Liniment, 

Hartshorn, Poisoning by Spirits 

of 
Hasty Consumption. 
Hay Asthma, . . . .452 
Hay Fever, 
Headache, 

Head Lice, 646 

Health Boards, . 

Health Contagious, . . 216, 218 

Heartburn, 486 

Heart Diseases, . . . 428 

Hectic Fever, 

Hectic Flush, . . . .270 

Hemicrania, 

Hemiplegia, 

Hemlock Poisoning, . 

Hemorrhage, 

Hemorrhage, Etfects of 

Hemorrhage from the Lungs, . 463 

Hemorrhage from Wound: 

Hemorrhage of the Bowel: 

Hemorrhage of the Stomach. 

Hemorrhoids, 

Hepatitis, 

Heredity, 

Hernia, 505 

Hernia,Femoral . . . 506 

Hernia, Inguinal . . . 505 

Hernia, Scrotal . . . .505 

Hernia, Umbilical 

Hernia, Ventral . 

Hernia, Truss for 

Hernial Obstruction, 

Herpes, . 

Hibernation, 



233 
57 



672, 673 
. 508 

463, 487 
. 518 



713 



Hiccough, 

Hip Disease, 

Hives, 

Hoarseness, . 

Hobnailed Liver, , 

Hooping-cough, 

Hop Pills, • . 

Hordeolum, . 

Hornet Stings, 

Hospital Fever, 

How to Eat, .. 

Hump, 

Hydrocele, 

Hydrocephalus, 

Hydrophobia, 

Hydrothorax, 

Hygiene, 

Hygiene, Facts established by . 207 

Hygienic Laws versus Medicine, 112 

Hymen, Imperforate . . 599 

Hypertrophy of the Heart, . 429 

Hypochondriasis, . . 357 

Hypnotics, 698 

Hysteria 361 

Hysterical Epilepsy, . . . 360 

I 

Icterus, 489 

Idiocy, 357 

Idleness in Youth, . . .211 

Iliac Passion, 498 

Ilius, ..;... 498 

Imagination and Will, . . 213 
Impacted Feces, . . . .510 
Imperfect Digestion, . . 51 

Impetigo, . . . .641 

Impotence, 559 

Impregnation, .... 576 
Impure Air, Diseases from . 51 
Impurities in the Air, . . 137 
Incapacity Reviewed, . . 576 

Incomplete Fistula, . . .515 
Incontinence of Urine, . . 531 

Incubus, 342 

Incurved Toe-nails, . . .660 
Indian Cholera, . . . .271 
Indigestion, . . . 51,484 

Indoor Exercise, . . .144 
Infantile Colic, . . . .497 
Infantile Snuffles, . . .405 
Inflamed Testicles, . . .561 
Inflamed Uvula, . . .417 

Inflammation Defined, . 75, 230 
Inflammation of the Bladder, . 527 
Inflammation of the Bowels, . 495 
Inflammation of the Brain, . 329 
Inflammation of the Breasts, . 621 
Inflammation of the Ear, . . 389 
Inflammation of the Eye, . • 377 
Inflammation of the Eyelids, . 381 



nflammation of the Gullet, . 425 
nflammation of the Kidneys, . 521 
nflammation of the Larynx, . 438 
nflammation of the Liver, . 488 
nflammation of the Lungs, . 455 
nflammation of the (Esophagus, 425 
nflammation of the Pharynx. 418 
nflammation of the Pleura, . 453 
nflammation of the Spleen. . 493 
nflammation of the Stomach, . 482 
nflammation of the Testicles, 561 
nflammation of the Tonsils, . 420 
nflammation of the Urethra, . 563 
nflammation of the Uvula, . 417 
nflammatory Rheumatism, . 306 
influences of Respiration, . 47 

nfluenza, 394 

ngrowing Eyelashes, . . 382 
ngrowing Toe-nails, . . 660 

nguinal Hernia, . . . 505 

nguinal Strangulation, . . 512 
injuries to Ganglia, ... 81 
inoculated Diseases, . . .274 

nsanity, 350 

nsolation, 334 

nsomnia, 341 

nspissated Cerumen, . . 390 
nstinct in every Organ, . . 30 
nsufficiency of Milk, . . 624 

ntemperanoe, a cause of Insanity 357 
intercommunication of Nerves, 89 
ntermittent Fever,. . . 241 

nternal Piles, .... 518 
ntestinal Juice, .... 42 
ntoxication, . . . 295, 344 

ntussusseption, . . . 514 

nvalids, Diet, for, . . .227 
nvalids, Exercise for . . 227 
nvalids' Food, . . . .127 
n version of the Womb, . . 606 
nward Fits, . . . .367 

odine, Poisoning by . . 289 

odism, 289 

ron in the Eye, . . . .384 

irrigator, 617 

rritation, 230 

rritation of the Bladder, . . 526 
rritation of the Spine, . . 627 

schuria, 53o 

ten, 639 

tching from Poison Vine, . 281 
tching of the Genitals in Preg- 
nancy, 581 

Ivy Poisoning, .... 281 



Jail Fever, 

Janders, 

Jaundice, 



Kerosene Lamp Explosion, 
Kidney Diseases, 
Kidneys, Bright's Disease of the 
Kidneys, Congestion of the 
Kidneys, Functions of the 
Kidneys, Inflammation of the . 
King's Evil, .... 

King's Yellow Poisoning, 
Kleptomania, .... 
Knee-joint Disease, . • 

Knock-knees 

Knowledge of Medicine Neces- 
sary, 



Labor. Natural .... 
Labor Pains Avoided, 
Labor, Premature 
Labor, True and False Pains in 
Lame Back, .... 

Lamp, Explosion of Kerosene 
Lancing the Gums, 
Laryngismus Stridulus, . 
Laryngitis, . . . . 

Larynx, Inflammation of . 
Laudanum Poisoning, 
Laurel Water Poisoning, . 
Lead Colic, .... 

Lead Poisoning by Cooking 

Utensils, .... 

Lead, Test for . 

Lepra, 

Leucocythnemia, 
Leucorrhcea, .... 

Lice 

Lichen, 

Ligature of Arteries, 

Lightning Stroke, 

Lime in the Eye, ... 

Lime, Poisoning by . 

Liniment, Aconite 

Liniment, Hartshorn 

Liver, Atrophy of the 

Liver, Cancer of ... 

Liver, Fatty .... 

Liver, Hobnailed or Granular 

Liver, Inflammation of the 

Liver, Other Diseases of the . 

Liver Spots, 

Liver Stains, 

Liver, Waxy 

Local Baths, 

Local Diseases, . 

Lockjaw, 

Locomotor Ataxia, 

Lodgments in the Throat, 

Longevity, . 

Long Round Worm, . 

Long Thread Worm, 



Looseness of the Bowels, . 506 

Loose Teeth 408 

Loss of Blood, .... 233 
Loss of Voice, . . . .443 

Love, 572 

Lumbago, 308 

Lumbar Abscess, . . 653 

Lung Abscess, .... 475 
Lung Apoplexy, . . .476 

Lung Collapse, . . . .475 
Lung Consumption, . . . 459 
Lung Diseases, .' . . 434 

Lung Emphysema, . . . 475 
Lung Fever, . . . .455 

Lung Gangrene, . . . 475 

Lupus Cancer, .... 320 
Lye, Poisoning by . . . 285 
Lymphatis Glands, ... 44 



Machine, Electrical ". . 692 

Magnesia, Calcined . . .694 
Malarial Fever, .... 245 
Malignant Boil, . . . . 653 
Malignant Fever, . . . 252 
Malposition of the Eyes, . . 382 
Mammary Abscess, . . .622 

Mania, 357 

Mania a Potu, . . .297 

Mania following Childbirth, . 598 
Mania in Pregnancy, . . .581 
Man's Diseases, . . . .535 
Marasmus, . . . . . 327 
Marriage, Essay on . . . 175 
Mashed Fingers or Toes, . . 673 

Mastitis, 621 

Mastodynia Apostematosa, . 622 
Masturbation, .... 539 
Matches, Poisoning by . . 290 
Maternity, Consideration of 

Objections to ... . 575 
Maternity, Requirements of . 578 
Matrikonine, . . . .608 
Maxillary Abscess, . . .403 

Measles, 257 

Measures, Glass, . . .703 
Meat as Food, .... 115 
Meat, Bolus of, in the Throat 

or Gullet 422,426 

Meat for Brain-workers, . . 116 
Medical Appliances, . . 688 

Medical Practice. Introductory 

Chapter, .... 193 

Medical Terms Defined, 16 

Medical Treatment, . . 229 

Medicinal action of W r ater, . 225 

Medicine Chest 704 

Medicines, a List of Domestic 704 
Medicines, Domestic, Uses of 694 
Medicines in Smaller Doses, . 204 
Medicines, Spurious . . 700 



715 



Medicine verms Hygienic Laws, 

Medulla Oblongata, the .« 

Melancholia, 

Membranous Croup, 

Meningitis, 

Menopausis, 

Menorrhagia, 

Menstruation, Excessive 

Menstruation, Painful 

Menstruation, Profuse 

Menstruation, Suppressed 

Mental Derangement, 

Mental Faculties, 

Mercury, Poisoning by 

Miasmatic Diseases, . 

Miasmatic Fever, 

Milk Abscess, 

Milk Crust, . 

Milk Fever, 

Milk Leg, 

Milk, Scanty 

Milk Spots, 

Milk, to Dry up the . 

Miscarriage, 

Model Physician, the 

Moist Tetter, 

Moles, 

Mollities Cerebri, 

Monomania, 

Morning Sickness, 

Morphine Pills, 

Morphine Poisoning, 

Mortality Causes, Greatest 

Mortification, 

Mosquito Bites, 

Mother's Mark, . 

Motion, Nerves of 

Mourning Suits, . 

Mouth, Nursing Sore 

Mumps, 

Muriatic Acid Poisoning, . 2 

Muriate of Ammonia Poisoning, 2 

Muriate of Antimony Poisoning, 2 

Muscle Diseases, . . . £ 

Muscles, Nerves of 

Muscular Rheumatism, . S 

Mushrooms, Poisoning by . 2 

Mustard Plaster, . . .6 

Myocarditis, . . . . 4 

Myopia, . . . . . I 

Mysteries of Medicine, . . 1 

N 



Naevus, 644 

Nails, 633 

Nails, Ingrowing, . . .660 
Naps, After-dinner, . . .153 
Nasal Catarrh, . . . .394 



Nausea in Pregnancy, 



Near-sightedness, . . .386 

Neck, Wry 309 

Necropneumonia, . . . 475 
Necrosis, . . .-"•'. . 680 
Needles in the Throat, . . 422 
Neglect in Urinating causing Fe- 
male Diseases, ... 68 

Nephritis, 521 

Nerve-centres, Functions of 79,80 
Nerve-pain, . v . . .370 

Nerves of Special Sense, . 91 

Nerves to each Muscle, . . 26 
Nervous Diseases, . . .210 
Nervous Energy, the . . 105 

Nervous Fever, . . . .247 
Nervous Headache, . . .337 
Nervous System, the . . 77 

Nettle rash, . . . .639 

Neuralgia, 370 

Neuralgic Headache, . . 338 

Neuromimesis, .... 374 
Nightmare, .... 342 

Night Sweats, . . . .270 
Nine-day Fits, . . . .367 
Nipples, Sore . . . .624 
Nitrate of Potash Poisoning, . 285 
Nitre Compound, . . .695 
Nitric Acid Poisoning, . . 285 
Nocturnal Emissions, . 535, 538 
Noli-me-tangere, . . . 320 

Nosebleed, 406 

Nose, Foreign Substances in the 392 
Nursing, Hints upon . . . 225 
Nursing Sore Mouth, . . . 407 
Nutmeg Liver, . . . .490 
Nutrition, . . . 34 

Nutrition, Process of . . 37 

Nux Vomica, Poisoning by . 290 



Obesity, 667 

Objections to Maternity Consid- 
ered, 575 

Obstructions in the Bowels, . 510 
Occupations, Hereditary Kffects 
of Debilitating . . . 222 

CEdema 314 

Oesophagitis, . . . .425 
Oesophagus, Foreign Bodies in 426 
Oesophagus, Inflammation of . 425 
Oesophagus, Stricture of . . 426 
Offensive Breath, . . .408 
Offensive Odors of the Skin, . 635 
Offices of the Blood, . . 46 

Oil Glands, .... 633 

Oil of Bitter Almonds, Poisoning 

by 285 

Oil of Vitriol Poisoning, . . 285 
Ointments, . . . .698 

Old Sores, 674 

Onanism, .... ^ 539 



716 



Opacity of the Cornea, 

Opacity of the Crystalline Lens, 

Ophthalmia, 

Ophthalmia Tarsi, 

Opium Eating Habit, 

Opium Pills, 

Opium Poisoning, 

Orchitis, 

Organic Diseases, 

Organic Matter Poisonous, 

Oriental Cholera, 

Otitis 

Otorrhcea, . 
Overstrain, . 
Over-work of Farmers, 
Oxalic Acid Poisoning, 
Oxide of Antimony Poisoning 
Oxide of Arsenic Poisoning, . 
Ozsena, 



Psedatrophia, 

Painful Menstruation, 

Painless Death, . 

Pains in Labor, . 

Pains in Labor Avoided, 

Painters' Colic, . 

Palpitation in Pregnancy, 

Palpitation of the Heart, 

Palsy, .... 

Pancreatic Juice, 

Papulous Scall, . 

Paraylsis, 

Paraplegia, 

Parasitic Diseases 

Paregoric Poisoning, 

Paris Green, Poisoning by 

Parlor Gymnasium, . 

Paronychia, 

Parotitis, 

Parturition, 

Pearlash, Poisoning by 

Peas in the Ear or ISose, 

Pecularities of the Skin, 

Pemphigus, 

Penetrating Wounds, 

Pepsin, .... 

Perforation of the Stomach, 

Pericarditis, 

Perineal Supporter, 

Perineum, Rupture of, in Labor 

Peritonitis, 

Permanent Snuffles, 

Pernicious Fever, 

Pertussis, 

Pessaries, 

Pestilential Cholera, 

Petechial Fever, . 

Pharmacy, 

Pharyngitis, 

Phlegmatia Dolens, 



516, 613, 614 



Phlegmonous Erysipelas, . 648 

Phosphorus and Nux V. Pills, 699 

Phosphorus Poisoning, . . 290 

Phrenitis, 329 

Phrenology, 94 

Phthisis Pulmonalis, . . .459 

Physician, the Model . . 201 

Physician's Attainments, . . 199 

Physician's Duty In Contagion, 205 

Physician's Status, ... 200 
Pile Pessary, . . . .516 

Piles, 518 

Pills, Anti-bilious . . . 695 

Pills, Anti-malarial ... 696 

Pills, Hop 698 

Pills, Morphine . . . .698 
Pills, Opium . . .698 

Pills, Phosphorus and Nux V, 699 

Pimples, 634 

Pimples on the Face, . . 634 

Pins in the Throat or Gullet . 427 

Pin Worms, .... 300 

Pityriasis Capitis, . . 643 

Placenta, . 586 

Playthings in the Air-passage, 476 

Pleurisy 453 

Pleuritis, 453 

Pleurodynia, .... 678 

Pleuro-pneumonia, . . • 453 

Pneumogastric Nerve, the - 101 

Pneumonia, , 455 

Pneumothorax, .... 475 

Pneumotostema, .... 475 

Pocket Inhaler, .... 440 

Podagra, 311 

Poison-hemlock, Poisoning by 288 
Poisoning by Lead in Cooking 

Utensils 128 

Poisoning by Vines and Shrubs, 281 

Poison-parsley, Poisoning by . 2S8 

Poisons and their Antidotes, . 283 
Poison, Unknown, Treatment of 292 

Polypus of the Nose, ... 403 
Popular Knowledge, Necessity of 197 

Pork Parasite, .... 304 
Pork Poison, . . . .304 

Porrigo, 646 

Portable Turkish Bath, . . 171 

Potash, Poisoning by . . . 285 

Patassium Poisoning, . . 290 

Pott's Disease 629 

Powder, Composition . . 699 

Pox, 569 

Practitioners, , 194 

Pregnancy, Diseases of . . 580 

Pregnancy, Signs of . . . 579 

Premature Labor, . . 591 

Preparing the Bed for Labor,. . 582 

Presbyopia, 386 

Preservation of the Sight, . 385 

Preservation of the Teeth, . 412 

Prickly Heat, .... 641 



Process of Nutrition, 



Proctocele, 


. 516 


Professional Errors, . 


. 204 


Profuse Menstruation, 


. 603 


Progressive Locomotor Ataxia, 346 


Prolapsus Ani, 


. 516 


Prolapsus Uteri, 


. 600 


Proper Food, . 


. 224 


Proper Medical Treatment 


. 193 


Prostatitis, 


. 530 


Protection of Vision, . 


. 385 


Proud Flesh, 


. 679 


Prurigo, .... 


. 641 


Pruritus Vulvae, . 


. 641 


Prussic Acid Poisoning, 


. 285 


Psoas Abscess, 


. 653 


Psoriasis, .... 


. 643 


Puberty, 


53, 573 


Puerperal Convulsions, 


. 597 


Puerperal Eclampsia,. 


. 597 


Puerperal Fever, . 


. 595 


Puerperal Mania, . 


. 598 


Pulmonary Apoplexy, 


. 476 


Punctures, 


. 673 


Pure Air, 


. 135 


Purging, .... 


. 506 


Purulent Sore Eyes, . 




Purulent Urine, 


. 521 


Pustules, .... 


. 641 


Putrid Fever, 


. 252 


Putrid Measles, 


. 259 


Pyaemia, .... 


. 680 


Pyelitis. 


. 521 


Pyrexia, 


. 235 


Pyrosis, 


. 485 


Q 




Quackery, 


. 196 


Quality of the Urine, . 
Queen's Hoot Alterative, 


. 65 


, 695 


Quickening, . 


. 579 


Quinsy, .... 


420 


R 




Rabies, '. 


. 274 


Rachitis, 


. 293 


Rat-poison, poisoning by 
Ratsbane, poisoning by 


. 290 


. 286 


Realger poisoning, 


. 286 


Rectitis, .... 


. 508 


Rectum, Falling of the 


. 516 


Rectum Speculum, 
Rectum, Stricture of the 


. 515 


. 517 


Red- gum, 

Red Precipitate Poisoning 


. 639 


. 289 


Red Sulphuret Poisoning, 


. 286 


Remedial Power, Nature 




source of . , 


. 203 


Remittent Fever, . 


. 245 


Renal Congestion, 


. 521 



Requisites for Dwellings, 
Reserve Force, 
Respiration, . 
Respiration, Artificial 
Respirator, 
Respirator, Anti-dust 
Respiratory Brace, 
Rest, .... 

Restoration of the Apparently 

Dead, .... 
Results of Exercise, . 
Retained Placenta, 
Retention of Urine, 
Retroflexion of the Womb, 
Retroversion of the Womb, 
Revulsives, 
Rheumatic Headache, 
Rheumatic Gout, 
Rheumatism, Acute . 
Rheumatism, Chronic 
Rheumatism, Gonorrhoeal 
Rickets, .... 
Ringworm, 

Ringworm of the Scalp. 
Rose Catarrh, 
Roseola, 
Rose Rash, 
Rubeola, 

Rules for Long Life, . 
Running from the Ear, 
Running Tetter, . 
Runround, 
Rupture, Hernial . 
Rupture of Perineum, 
Russian Baths, 



Saint Ignatius' Bean, Poisoning 

by .... 

Saint Vitus's Dance, 
Sal Ammoniac Poisoning, 
Saltpetre, Poisoning by 
Salt Rheum, . 
Salt Rheum Ointment, 
Salts of Sorrel Poisoning, 
Sand m the Eye, . 
Sarcocele, 

Sausage Poison, . . » 
Scabies, .... 
Scalds, .... 
Sealled Head, 
Scarf-skin, 
Scarlatina, . 
Scarlatina Anginosa, . 
Scarlatina Maligna, 
Scarlatina Simplex, 
Scarlet Fever, 
Scars, to remove . 
Seheele's Green, Poisoning 
Schools of Medicine, 
Sciatica, . 



by . 286 



718 



Scirrhus Cancer, . . . .320 

Scorbutus 293 

Scrofula 32.5 

Scrofulous Consumption, . . 459 
Scrofulous Diseases, . . .326 

Scrotal Hernia 505 

Scrotal Supporters, . . - 562 

Scurvy, 203 

Seasickness, 483 

Secretion, 34 

Self-abuse, 539 

Self-pollution, . . . .539 
Seminal Losses, . . . .535 
Sensibility, Nerves of . . .91 
Sewage arid Drainage, . . 165 
Sexual Sins, .... 221 

Shakes 241 

Shaking Palsy, .... 368 

Shingles 640 

Ship Fever, 252 

Short Breath, . . . .476 

Short Sight 3S6 

Shoulder Brace . . . .630 
Shower Bath, . . . .168 

Show, the 5S2 

Shrub Poisoning, . . . .281 
Sick, Close Confinement of the 207 
Sick Headache, . . . .337 
Sickness in the Farm-house, . 208 

Sideache 631 

Signs of Pregnancy, . . . 579 

Singultus, 487 

Skin, Anatomy of the . 69, 70, 632 
Skin Diseases, .... 632 
Skin, Functions of the . . 69 

Sleep 152 

Sleeping together, . . . 153 
Sleeplessness, .... 341 
Sleep-walking, . . . .344 
Smaller Doses, . . . .204 

Small-pox 265 

Smoke Producing Apparent 

Death 479 

Smokers' Eyes, .... 384 

Smothering, 477 

Snake Bites, 278 

Sneezing, Persistent . . .437 

Snoring, 423 

Snuflles 394,404 

Snu files, Permanent . . . 394 
Social Causes of Nervou9 

Diseases, 210 

Soft Cancers, 321 

Soft Corns, ... - . 657 
Softening of the Brain, . . 34/ 
Somnambulism, .... 344 
Somnolency, . . . .344 

Soothing Syrup, Poisoning by . 290 
Sore Nipples, .... 624 

Sores, Old t>74 

Source of Remedial Power, . 203 
Sour Stomach, . . . 4S4, 6J7 



Spanish Fly, Poisoning by 

Spasmodic Cholera, . 

Spasmodic Cough, 

Spasms, . 

Spermatorrhoea, .... 

Spider Bites, . . . , 

Spinal Curvature, 

Spinal Irritation, 

Spinal Nerves, ... 87, 

Spirits of Hartshorn Poisoning, 

Spirits of Salt Poisoning, . 

Spirit-vapor Bath, 

Spirometer, 

Spitting Blood, .... 
Spleen, Inflammation of the . 

Splenitis, 

Spongy Gums, .... 
Spotted Acne, .... 
Spotted Fever, .... 

Sprains, 

Sprays, 

Spurious Drugs, .... 

Squinting, 

Stabs, 

Stammering, 

Starchy Foods for Infants, 
Steel Points in the Eye, 

Sterility, 

Stimulants, 

Stings from Bees, Wasps, Hor- 
nets, etc., 

Stinking Feet, .... 

Stitches, 

Stomach, 

Stomach, Cancer of the 

Stomach, Hemorrhage of the 463, 

Stomach, Inflammation of the 

Stomach, Ulcer of the 

Stomach Worms, 

Stomatitis, 

Stone, 

Stone in the Bladder, 

Strabismus, . 

Strains, . 

Strangling, 

Strangulation of the Bowels, 

Stranguria, 

Stricture of the Gullet, 

stricture of the (Esophagus, 

Stricture of the Rectum, 

stricture of the Urethra, 

Structural Disease, 

Strychnine Poisoning, 

Stun, .... 

Stuttering, 

Styes, .... 

Styptics, 

Subaeetate of Copper Poisoning, 

Substances in the Ear, 

Substances in the Eye, 

Substances in the Gullet, 

substances in the Nose, 



422, 



719 



072 



Substances in the Throat, . . 426 
Substances in the Windpipe, . 476 

Sudden Death, . . . . 6S3 

Suffocation 477 

Sugar in the Urine, . . . 525 

i uicide, 426, 477 

Sulphate of Copper Poisoning, 288 
Sulphate of Zinc Poisoning, . 291 
.Sulphuric Acid Poisoning, . 285 
Summer Catarrh, .... 452 
Summer Complaint, . . .501 

Sunburn, 644 

Sunlight, ...... 141 

Sunstroke, 334 

Suppository Syringe, . . 520 

Suppression of the Menses, . 599 
Suppression of Urine, . . 534 
Surface Cancers, . . .321 

Surfeit in the Adult, . 
Surgical Diseases, 
Suspended Animation, 
Suspended Animation, Voluntary 28 
Suspended Respiration, . . 49 
Suspensory Bandage, . . . 317 

Sweat Glands, . . . .633 
Sweating, Excessive . . . 270 
Swelled Testicle, . . .561 

Swelling of Feet in Dropsy, . 314 
Swelling of Feet in Pregnancy, 579 
Swelling of the Knee, . . 631 

Swimming of the Head, . . 432 

Swooning, 431 

Sympathetic Nervous Sys- 
tem 78,85,86. 

Syncope, 431 

Syncope, Physiology of . . 50 

Syphilis, 569 

Syrup, Alterative, for the Blood 695 
Syrup for Coughs and Colds, . 695 



Tabes Glandularis, 

Tabes Mesenterica, 

Taenia Solium, 

Tan, .... 

Tape "Worm, 

Tartaric Acid Foisoning, 

Tarter Emetic Poisonmg, 

Technical "Words Denned, 

Teeth, Care of the 

Teeth, Decaying 

Teething, 

Teething Rash, . 

Teeth, Loose 

Tenderness of the Spine, 

Test for Lead, 

Testicles, Inflamed . 

Testicles, Swelled 

Tetanus, 

Tetter, 

Theories of Medicine, 



Things in the Ear, . . .392 
Things in the Eye, . . . 383 
Things in the Gullet, . . 426 

Things in the Nose, . . . 392 
Things in the Throat, . . 426 

Things in the Windpipe, . . 476 
Thread Worm, . . . .300 
Throat, Foreign Substances in 

the 422,426 

Throat, Sore .... 418 

Thrush 407, 624 

Tic Douloureux, . . . 373 

Tip Battery, .... 693 

Tobacco Poisoning, . . .291 
Toe-nails, Ingrowing, . . 660 
Toes, Mashed or Crushed . 673 

Tonsilitis, , 420 

Tonsils, Inflamed . . .420 
Toothache, . . . . 410 

Toothache in Pregnancy, . . 581 
Torticollis, .... 309 

Touch-me-not 320 

Trachea, Foreign Substances in 

the 476 

Trachoma, 379 

Trance, 363 

Transmission of Disease, . .220 

Travail, 582 

Treatment, Medical . . .229 
Trembling Palsy, . . . 368 
Tremor, .... 33ft, 368 
Trichiniasis, . . . .304 

Trico ephalus, . . . .300 
Trifacial Nerve, ... 98, 99 
Trismus Nascentium, . . 367 

True Croup, . . . .441 

True Skin 632 

Truss for Hernia, . . .688 
Tubercular Diseases, . . 325 

Tumors and Cancers, Difference 

Between 320 

Tumors of the Womb, . . 609 
Turbpeth Mineral, Poisoning by 289 
Turkish and Russian Baths, . 170 
Turn of Life, . . . .624 
Typhoid Fever, .... 247 
Typhus Fever, .... 252 

U 

Ulceration of the Antrum, . 403 
Ulceration of the Womb, . . G05 
Ulcer of the Stomach, . . 48 J 

Ulcers, 674 

Umbilical Hernia, . . 505 

Unknown Poison, Treatment of 292 

Urasmia, 524 

Urethra, Stricture of the . . 566 

Urinals, 533 

Urinary Calculus, . . . 492 
Urine, Abnormal ... 67 
Urine, Bloody . . . .524 



720 



Urine, Incontinence of 

Urine. Purulent. 

Urine. Quality of the 

Urine. Retention of 

Urine, Sugar in the 

Urine. Suppression of . . 534 

Urticaria 639 

Uterine Catarrh. . . . M9 

Uterine Complaints, 

Uterine Displacements, 

Uterine Pessaries, 

Uterine Prolapsus, . 

Uterine Tumors, 

Uterus. Flexion of 

Uterus, Version of 

Uvula, Dropped or Elongated 



Vaccination 267 

Vaginal Catarrh, . . . bio 

Vaginal Speculum, . . . 605 

Vaginitis, 604 

Valvular Disease of the Heart, 428 
Vampirism, . . . - 217 

Varicella, 268 

Varicocele, 561 

Varicose Ulcer, .... 67o 
Varicose Veins, .... 676 

Variola, 265 

Varioloid 266 

Vegetable Diet 121 

Venereal Diseases, . . 563, 569 
Venom of Insects and Animals, 58 
Ventilation, . • . . . 139 

Ventilation of Bed-rooms, . 139 

Ventral Hernia, .... 505 

Veratrum, 699 

Veratrum Viride Poisoning, . 291 
Verdigris, Poisoning by . . 288 
Vermes Intestini, . . .300 
Vermillion. Poisoning by . . 289 
Versions of Uterus, . . .605 

Vertigo, 43-2 

Vesical Calculus, . . .492 
Vesical Irritation, . . . 526 
Vicarious Menstruation, . . 599 
Nine Poisoning, .... 281 
Virion, Defective . . .386 
Vision, Protection of . 385 
Vital Operations, ... 83 
Vital Principle .... 29 
Vital Properties, . . . '25 
Vomiting Blood, . . .463 
Vomiting in Inflamed Stomach, 482 
Vomiting in Pregnancy, . . 580 
Vulvitis, 603 

W 

Wakefulness, . . . .341 
Wall-paper, Arsenic in . . 132 



Warts, . 
Wasp Stings, 
Water, . 
Water Blisters, 
Water-brash, 
Water-hemlock, Poisoning by 
Water, Medicinal action of 
Watery Blebs, .... 
Watery Eyes, .... 
Wax in the tar, Hardened 
Waxy Liver, .... 

Weakness, 

Weaning 

Webbed Fingers from Scalds, . 
Wedding Journeys 

Wens, 

W r et Dreams, . . . 535, 
Wet-sheet pack, .... 

Wheat, 

White Arsenic Poisoning, 

White-gum 

White Ointment, 

White Precipitate Poisoning, . 

White Swelling 

White Vitriol Poisoning, . 

Whites 

Whitlow 

Whooping-cough, 

Will, Force of ... . 

Wind Colic 

Wind Dropsy, .... 
Wind in the Chest, 
Wind-pipe, Foreign substances 

in 

Wolf Cancer, .... 
Womb Diseases, .... 
Womb Displacements, 
Womb, Falling of the 
Women's Diseases, 
Women's Dress, .... 
Worm Fever, .... 

Worms, 

Worry 

Wounds, 

W T ryneck, 



Yellow Atrophy of the Liver . 490 

Yellow Fever, .... 255 

Yellow Jack, .... 255 

Yellows 489 

Yellow Sulphuret of Arsenic . 

Poisoning 286 



Zinc Poisoning, . 
Zymotic Diseases, 



LIBRARY OF CONGRESS 

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